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In Mayo Clinic proceedings. Innovations, quality & outcomes

OBJECTIVE : To test the hypothesis that the MASS Score performs consistently better in identifying need for monoclonal-antibody infusion throughout each "wave" of SARS-CoV-2 variant predominance during the COVID-19 pandemic and the infusion of contemporary monoclonal-antibody treatments is associated with a lower risk of hospitalization.

PATIENTS AND METHODS : In this retrospective cohort study, we evaluated the efficacy of monoclonal-antibody treatment as compared to no monoclonal-antibody treatment in symptomatic adults who tested positive for SARS-CoV-2, regardless of their risk factors for disease progression or vaccination status during different periods of SARS-CoV-2 variant predominance. The primary outcome was hospitalization within 28 days after COVID-19 diagnosis. The study was conducted on patients diagnosed with COVID-19 from November 19, 2020, through May 12, 2022.

RESULTS : Of the included 118,936 eligible patients, hospitalization within 28 days of COVID-19 diagnosis occurred in 2.52% (456/18,090) of patients who received monoclonal-antibody treatment and 6.98% (7,037/100,846) of patients who did not. Treatment with monoclonal-antibody therapies was associated with a lower risk of hospitalization when using stratified data analytics, propensity scoring, and regression and machine learning models with and without adjustments for putative confounding variables, such as advanced age and coexisting medical conditions (e.g., relative risk: 0.15; 95% CI, 0.14 to 0.17).

CONCLUSIONS : Among patients with mild to moderate COVID-19, including those who have been vaccinated, monoclonal-antibody treatment was associated with a lower risk of hospital admission during each wave of the COVID-19 pandemic.

Johnson Patrick W, Kunze Katie L, Senefeld Jonathon W, Sinclair Jorge E, Isha Shahin, Satashia Parthkumar H, Bhakta Shivang, Cowart Jennifer B, Bosch Wendelyn, O’Horo Jack, Shah Sadia Z, Wadei Hani M, Edwards Michael A, Pollock Benjamin D, Edwards Alana J, Scheitel-Tulledge Sidna, Clune Caroline G, Hanson Sara N, Arndt Richard, Heyliger Alexander, Kudrna Cory, Bierle Dennis M, Buckmeier Jason R, Seville Maria Teresa A, Orenstein Robert, Libertin Claudia, Ganesh Ravindra, Franco Pablo Moreno, Razonable Raymund R, Carter Rickey E, Sanghavi Devang K, Speicher Leigh L


CMH, Cochran Mantel Haenszel, COVID-19, Coronavirus Disease 2019, GBM, Gradient Boosting Machine, MASS, Monoclonal Antibody Screening Score, SARS-CoV-2, Severe Acute Respiratory Syndrome Corona Virus 2