{"pk":15256,"title":"Bamlanivimab Reduces ED Returns and Hospitalizations and May Reduce COVID-19 Burden on Low-resource Border Hospitals","subtitle":null,"abstract":"Introduction:\n To evaluate the effectiveness of bamlanivimab at reducing return emergency department  (ED) visits in primarily Latinx/Hispanic patients with mild or moderate coronavirus disease 2019  (COVID-19). Secondary aims were to evaluate the prevention of subsequent hospitalizations and deaths  in a resource-limited United States (U.S.)-Mexico border hospital.\nMethods:\n We conducted a retrospective, open-label interventional study on 270 eligible adult patients  diagnosed with mild-moderate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection  who met criteria for receiving bamlanivimab from November 1, 2020 to January 31, 2021. The main  outcomes of 14-day return visits to the ED and hospitalizations due to COVID-19 were compared  between two groups – those who received bamlanivimab (exposed group) and those who did not receive  bamlanivimab (unexposed group). Outcomes were analyzed through chi-square tests followed by  multivariate regression modeling to adjust for patient demographics, characteristics, and comorbidities.\nResults:\n There were 136 COVID-19 patients who received bamlanivimab in the ED prior to discharge  and an unexposed group of 134 COVID-19 patients who were evaluated and discharged from the  ED without receiving bamlanivimab. Overall, mean age was 61.7 (S.D. +/-13.9) years, mean body  mass index (BMI) 31.0 (S.D. +/-6.6) kg/m2 , 91.5% identified as Latinx/Hispanic, 51.9% male, and  80.7% reported at least one comorbidity. Most commonly reported comorbidities were obesity (22.6%),  hypertension (59.6%), and diabetes (41.1%). The bamlanivimab group had a 22.8% (mean estimate  = 0.7717, 95% CI [0.6482, 0.8611]) risk reduction or 84.4% (0.3030, 95% CI = 0.166, 0.554, p=.0001)  absolute reduction of ED return visits within 14 days compared to controls after adjusting for chronic  kidney disease. The bamlanivimab group had 19.0% (mean estimate=0.8097, 95% CI [0.6451, 0.9087])  risk reduction or 96.2% (0.235, 95% CI 0.100, 0.550, p=0.0008) absolute reduction of subsequent  hospitalizations compared to unexposed patients after adjusting for diabetes status.\nConclusion:\n Bamlanivimab infusions for high-risk COVID-19 patients in the ED substantially reduced  the risk of return visits to the ED and hospitalizations in our primarily Latinx/Hispanic population.  Monoclonal antibody infusions may help reduce hospital utilization during COVID-19 surges at U.S.- Mexico border hospitals. [","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"monoclonal antibody, bamlanivimab, SARS-CoV-2, Coronavirus Disease 2019, COVID-19"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/3bs7s4dj","frozenauthors":[{"first_name":"Faith","middle_name":"C.","last_name":"Quenzer","name_suffix":"","institution":"San Diego State University School of Public Health, San Diego, California; University of California – San Diego, School of Medicine, Department of Emergency Medicine, San Diego, California; El Centro Regional Medical Center, Department of Emergency Medicine, El Centro, California","department":"None"},{"first_name":"Andrew","middle_name":"T.","last_name":"Lafree","name_suffix":"","institution":"University of California – San Diego, School of Medicine, Department of Emergency Medicine, San Diego, California; El Centro Regional Medical Center, Department of Emergency Medicine, El Centro, California","department":"None"},{"first_name":"Londyn","middle_name":"","last_name":"Grey","name_suffix":"","institution":"Louisiana State University Health Sciences Center, School of Medicine, Shreveport, Louisiana","department":"None"},{"first_name":"Sukhdeep","middle_name":"","last_name":"Singh","name_suffix":"","institution":"University of California – San Diego, School of Medicine, Department of Emergency Medicine, San Diego, California; El Centro Regional Medical Center, Department of Emergency Medicine, El Centro, California","department":"None"},{"first_name":"Cameron","middle_name":"","last_name":"Smyers","name_suffix":"","institution":"University of California – San Diego, School of Medicine, Department of Emergency Medicine, San Diego, California; El Centro Regional Medical Center, Department of Emergency Medicine, El Centro, California","department":"None"},{"first_name":"Bruce","middle_name":"","last_name":"Balog","name_suffix":"","institution":"El Centro Regional Medical Center, Department of Emergency Medicine, El Centro, California","department":"None"},{"first_name":"Henry","middle_name":"","last_name":"Montilla Guedez","name_suffix":"","institution":"University of California – San Diego, School of Medicine, Department of Emergency Medicine, San Diego, California","department":"None"},{"first_name":"Kaitlin","middle_name":"","last_name":"McIntyre","name_suffix":"","institution":"University of California – San Diego, School of Medicine, Department of Emergency Medicine, San Diego, California","department":"None"},{"first_name":"Sharon","middle_name":"","last_name":"Wulfovich","name_suffix":"","institution":"University of California – San Diego, School of Medicine, Department of Emergency Medicine, San Diego, California","department":"None"},{"first_name":"Juli","middle_name":"","last_name":"Ramirez","name_suffix":"","institution":"El Centro Regional Medical Center, Department of Emergency Medicine, El Centro, California","department":"None"},{"first_name":"Talia","middle_name":"","last_name":"Saikhon","name_suffix":"","institution":"El Centro Regional Medical Center, Department of Emergency Medicine, El Centro, California","department":"None"},{"first_name":"Christian","middle_name":"","last_name":"Tomaszewski","name_suffix":"","institution":"University of California – San Diego, School of Medicine, Department of Emergency Medicine, San Diego, California; El Centro Regional Medical Center, Department of Emergency Medicine, El Centro, California","department":"None"}],"date_submitted":"2021-04-02T15:42:01-04:00","date_accepted":"2021-04-02T15:42:01-04:00","date_published":"2022-03-17T23:10:19-04:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/15256/galley/7740/download/"}]}