1. Neutralizing Monoclonal Antibodies for Coronavirus Disease 2019 (COVID-19) in Pregnancy: A Case Series
- Author
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Michael Richley, Rashmi R. Rao, Yalda Afshar, Jenny Mei, Thalia Mok, Tara Vijayan, Stacey Weinstein, Christine U. Pham, Jason Madamba, Christina S. Shin, Deborah Suda, and Christina S. Han
- Subjects
Reproductive health and childbirth ,Antibodies, Monoclonal, Humanized ,Antibodies ,Vaccine Related ,Paediatrics and Reproductive Medicine ,Fetal Heart ,Pregnancy ,Clinical Research ,Biodefense ,Monoclonal ,Humans ,Pregnancy Complications, Infectious ,Obstetrics & Reproductive Medicine ,Neutralizing ,Humanized ,Lung ,Retrospective Studies ,Pediatric ,Overtreatment ,Prevention ,Infectious ,Obstetrics and Gynecology ,Antibodies, Monoclonal ,Pneumonia ,Health Services ,Antibodies, Neutralizing ,COVID-19 Drug Treatment ,Pregnancy Complications ,Drug Combinations ,Infectious Diseases ,Emerging Infectious Diseases ,Good Health and Well Being ,Female ,Immunization ,Biotechnology - Abstract
ObjectiveTo describe outcomes associated with monoclonal antibody use in pregnant persons with mild-to-moderate coronavirus disease 2019 (COVID-19).MethodsWe present a retrospective case series of pregnant patients who received anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monoclonal antibody infusions at a single center from April 1, 2021, through October 16, 2021. Pregnant patients who had a positive SARS-CoV-2 polymerase chain reaction (PCR) test result and mild-to-moderate COVID-19 symptoms were eligible for monoclonal antibody infusion. Exclusion criteria for administration included need for supplemental oxygen, hospitalization due to COVID-19, and positive SARS-CoV-2 PCR test result more than 7 days before screening. All patients received either bamlanivimab plus etesevimab or casirivimab plus imdevimab based on availability and dosing instructions of the product and emerging resistance patterns in the community.ResultsDuring the study period, monoclonal antibody infusions were administered to 450 individuals at our institution, of whom 15 were pregnant. Of the 15 pregnant persons receiving monoclonal antibody, six (40%) had full-vaccination status at the time of infusion. Two individuals (13%, CI 0-31%) experienced systemic reactions during the infusion, both resulting in temporary changes in the fetal heart rate tracing that recovered with maternal and intrauterine resuscitative efforts. One patient delivered after infusion for worsening maternal and fetal status; the remainder of the patients did not require admission for COVID-19.ConclusionIn this case series, pregnant persons who received anti-SARS-CoV-2 monoclonal antibody infusions had generally favorable outcomes.
- Published
- 2022