Effect of amubarvimab-romlusevimab for treatment of severe COVID-19 in intensive care units: A retrospective cohort study

Peng Qu; Anni Lou; Dan Rong; Canmin Wang; Qinglei Zhong; Wanfu Cui; Jiacheng Gong; Qihan Xu; Zhuoer Chen; Luqman Sadat Bathaiian; Xu Li; Cheng Chen

doi:10.1016/j.heliyon.2024.e37663

Effect of amubarvimab-romlusevimab for treatment of severe COVID-19 in intensive care units: A retrospective cohort study

Heliyon. 2024 Sep 11;10(18):e37663. doi: 10.1016/j.heliyon.2024.e37663. eCollection 2024 Sep 30.

Authors

Peng Qu^{1

2}, Anni Lou¹, Dan Rong¹, Canmin Wang³, Qinglei Zhong¹, Wanfu Cui¹, Jiacheng Gong¹, Qihan Xu¹, Zhuoer Chen¹, Luqman Sadat Bathaiian⁴, Xu Li¹, Cheng Chen⁵

Affiliations

¹ Department of Emergency Medicine, Southern Medical University Nanfang Hospital, Guangzhou, China.
² Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
³ Intensive Care Unit, Guangdong Second Provincial General Hospital, Guangzhou 510317, China.
⁴ School of Interatibnal Educgtior,Southern Medical University, Guangzhou, China.
⁵ Department of Critical Care Medicine, Baiyun Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Abstract

Amubarvimab-romlusevimab is a commonly recommended antiviral treatment in China for adult patients with mild or moderate SARS-CoV-2 infections, especially for patients with a high risk factor for progression to severe COVID-19. However, its exact efficacy in patients with severe Covid-19 is not yet known.This is a single-center retrospective cohort study, in which we collected the general data, laboratory tests, radiological characteristics, viral conversion status, and prognosis of the disease from patients with COVID-19 hospitalized, from December 2022 to March 2023 in the Department of Critical Care Medicine. The amubarvimab-romlusevimab therapy can reduce the 28-day mortality (29.79 % vs 51.35 %, p = 0.02), and ICU mortality (29.79 % vs 55.41 %, p = 0.006) of severe COVID-19.A 1:1 PSM (Propensity Score Matching) was performed to reduce bias, in order to ensure the two groups were balanced and comparable. In the matched population (n = 47), there were no statistically significant differences between the mAbs (monoclonal antibody)group and the Non-antiviral group in 28-day, and thromboembolic events in COVID-19 patients. The 40-day survival analysis shows that mAbs therapy can improve patient prognosis (HR = 0.45, 95%CI = 0.26-0.76, p = 0.008). However, no significant intergroup difference in the 40-day cumulative viral conversion rate. In a univariate Cox regression analysis, The Amubarvimab - romlusevimab therapy(HR:0.464; CI:[0.252-0.853]; p:0.013) is a protective factor and CRP, PCT, PLT, Lactate, PT, PT-INR, and pt% level at admission were risk factors for clinical prognosis. After including the above covariates, Multifactorial COX regression shows that the Amubarvimab - romlusevimab therapy(HR:0.392; CI:[0.211-0.729]; p:0.003), CRP, Lactate and PT-INR at admission are independent factors for mortality of severe COVID-19. Based on the current data, we conclude that amubarvimab-romlusevimab therapy is beneficial for patients with severe COVID-19.

Keywords: Amubarvimab; Antibody therapy; COVID-19; Intensive care Units; Romlusevimab; SARS-CoV-2.