J 2022

Successful early use of anti-SARS-CoV-2 monoclonal neutralizing antibodies in SARS-CoV-2 infected hematological patients - A Czech multicenter experience

WEINBERGEROVÁ, Barbora, Ivo DEMEL, Benjamin VISEK, Jan VALKA, Martin CERNAN et. al.

Basic information

Original name

Successful early use of anti-SARS-CoV-2 monoclonal neutralizing antibodies in SARS-CoV-2 infected hematological patients - A Czech multicenter experience

Authors

WEINBERGEROVÁ, Barbora (203 Czech Republic, guarantor, belonging to the institution), Ivo DEMEL (203 Czech Republic), Benjamin VISEK (203 Czech Republic), Jan VALKA (203 Czech Republic), Martin CERNAN (203 Czech Republic), Pavel JINDRA (203 Czech Republic), Jan NOVAK (203 Czech Republic), Lukas STEJSKAL (203 Czech Republic), Flóra KOVÁCSOVÁ (703 Slovakia, belonging to the institution), Tomáš KABUT (203 Czech Republic, belonging to the institution), Tomas SZOTKOWSKI (203 Czech Republic), Roman HAJEK (203 Czech Republic), Pavel ZAK (203 Czech Republic), Petr CETKOVSKY (203 Czech Republic), Zdeněk KRÁL (203 Czech Republic, belonging to the institution) and Jiří MAYER (203 Czech Republic, belonging to the institution)

Edition

Hematological Oncology, MALDEN, USA, WILEY-BLACKWELL, 2022, 0278-0232

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30205 Hematology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.300

RIV identification code

RIV/00216224:14110/22:00125823

Organization unit

Faculty of Medicine

UT WoS

000756686100001

Keywords in English

anti-SARS-CoV-2 monoclonal neutralizing antibodies; bamlanivimab; casirivimab; COVID-19; hematological malignancy; imdevimab; SARS-CoV-2

Tags

Tags

International impact, Reviewed
Změněno: 16/5/2022 13:59, Mgr. Tereza Miškechová

Abstract

V originále

COVID-19 significantly impairs survival rates among hematological patients when compared to the general population. Our prospective multicentre project analyzed early administration of anti-SARS-CoV-2 spike protein neutralizing monoclonal antibodies (NmAbs) - bamlanivimab (72%) and casirivimab/imdevimab (28%) - efficacy among hematological patients with early-stage COVID-19. Mortality rate was compared to a control cohort of 575 SARS-CoV-2 positive hematological patients untreated with any specific anti-COVID-19 therapy. 88 hematological patients with lymphomas, acute leukemias, and myeloma as their most frequent underlying diagnoses (72%) were evaluated with a 97 days median follow-up after NmAb administration. One third of patients (32%) were treated with an anti-CD20 monoclonal antibody before COVID-19 diagnosis. Median time between first COVID-19 symptom and NmAb administration was 2 days. When administering NmAb, 29%, 57%, 11%, 2%, and 1% of our patients had asymptomatic, mild, moderate, severe, and critical degrees of COVID-19, respectively. 80% of baseline asymptomatic patients remained asymptomatic following NmAb administration. Median duration of COVID-19 symptoms after NmAb administration was 2.5 days. Progression to severe/critical COVID-19 occurred among a total of 17% (15/88) of our cases and numerically higher with bamlanivimab versus casirivimab/imdevimab (21% vs. 8%; p = 0.215), and myelomas (29%), lymphomas (17%) and acute leukemias (18%), respectively. During final follow-up, nine deaths (10%) were recorded - all after bamlanivimab (p = 0.056) with 8% attributed to COVID-19. Regarding "remdesivir/convalescent plasma naive" patients, COVID-19 mortality rates were significantly lower in our NmAbs treated cohort compared to the control cohort of untreated SARS-CoV-2 positive hematological patients (6% vs. 16%, p = 0.020), respectively. Our study validated the safety and efficacy of NmAbs early use among hematological patients with newly diagnosed early-stage COVID-19 in terms of alleviating infection course and decreasing mortality. Results confirmed a more positive effect of a casirivimab/imdevimab combination versus bamlanivimab monotherapy.