Infect Chemother.  2022 Jun;54(2):258-265. 10.3947/ic.2022.0011.

Early Oxygen Requirement in Patients with Mild-to-Moderate COVID-19 Who Received Regdanvimab after DeltaVariant Outbreak

Affiliations
  • 1Departement of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 2Division of Infectious Diseases, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea

Abstract

Background
Regdanvimab is a monoclonal antibody targeted against the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and a treatment option for patients with mild-to moderate coronavirus disease 2019 (COVID-19). However, there has been limited information on the clinical effectiveness of regdanvimab in the Delta variant of SARS-CoV-2. Therefore, we aimed to investigate the effectiveness of regdanvimab after the Delta variant was dominant using chronological analysis of regdanvimab use in a real-world setting.
Materials and Methods
The electrical medical records of patients infected with mildto-moderate COVID-19 who received regdanvimab within 7 days of symptom onset were reviewed before (February – June 2021) and after (August – November 2021) the Delta variant became predominant in Korea. Clinical outcomes were assessed by the need for oxygen supplementation, time from symptom onset to oxygen requirement, in-hospital mortality, and length of hospitalization. To match the difference between the basic characteristics of the two groups, the clinical outcomes were compared again after 1 : 1 propensity score matching.
Results
Patients treated with regdanvimab in the Delta-predominant group were more likely to require oxygen supplementation (17.5% vs. 6.0%, P = 0.019) and had shorter times from symptom onset to supplemental oxygen use (mean ± standard deviation [SD]: 5.8 ± 2.8 vs. 10.0 ± 3.7, P = 0.007) than those in the control group. After propensity score matching, the percentage of patient requiring oxygen supplementation was higher (15.2% vs. 6.1%, P = 0.156), while the time from symptom onset to oxygen supplementation was significantly shorter in the Delta-predominant group (mean ± SD: 4.9 ± 2.1 vs. 10.0 ± 3.7, P = 0.007) than that in the control group.
Conclusion
Considering that high proportion of vaccinated patients in the Deltapredominant group, this finding suggests the uncertainty whether the effect of regdanvimab is maintained even during the Delta-predominant period. It is hence necessary to continuously monitor the effectiveness of regdanvimab as new SARS-CoV-2 variants emerge.

Keyword

SARS-CoV-2; Monoclonal antibody; Neutralizing antibody; Therapeutics; Mutation
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