{"pk":16068,"title":"More Accessible COVID-19 Treatment Through Monoclonal Antibody Infusion in the Emergency Department","subtitle":null,"abstract":"Introduction: \nMonoclonal antibody (MAB) infusion is the first treatment to manage coronavirus 2019 (COVID-19) in an outpatient setting. Yet increased risk of severe COVID-19 illness may occur from inequities in social determinants of health including access to quality healthcare. Given the safety-net nature of emergency departments (ED), a model that puts them at the center of MAB infusion may better reach underserved patients than models that require physician referral and distribute MAB at outpatient infusion centers. We examined characteristics of two groups of patients who received MAB infusion in the Robert Wood Johnson University Hospital (RWJUH) ED in New Brunswick, New Jersey: 1) patients who tested positive for COVID-19 in the ED and received ED infusion; and 2) patients who tested positive elsewhere and were referred to the ED for infusion. The process for the latter group was similar to the more common national model of patients testing COVID-19 positive in the community and then being referred to an infusion center for MAB therapy. \nMethods: \nWe performed a cross-sectional retrospective health record review of all adult patients presenting to the ED from November 20, 2020–March 15, 2021 who received MAB infusion at RWJUH ED (N = 486). Patients were identified through the electronic health record system by an administrative query, with manual chart review for any additional characteristics not available through the query. We compared the two groups using chi-squared tests for categorical variables and t-tests for continuous variables.\nResults:\n We found higher proportions of Black (18% vs 6% P < 0.001, statistically significant), Hispanic (19% vs 11% P = 0.02), Medicaid (12% vs 9% P = 0.01), and uninsured (17% vs 8% P = 0.01) patients who tested positive for COVID-19 in their ED visit and then received MAB therapy during their visit than patients tested elsewhere in the community and referred to the ED for MAB therapy.\nConclusion:\n These findings suggest that providing MAB infusion in the ED allows increased access for patients traditionally marginalized from the healthcare system, who may be at risk of longer disease duration and complications from COVID-19.","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":"COVID-19"},{"word":"emergency department"},{"word":"access to care"},{"word":"monoclonal antibody infusion"},{"word":"underserved populations"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9t43n0h3","frozenauthors":[{"first_name":"Sara","middle_name":"W.","last_name":"Heinert","name_suffix":"","institution":"Rutgers Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, New Jersey","department":"None"},{"first_name":"Jonathan","middle_name":"","last_name":"McCoy","name_suffix":"","institution":"Rutgers Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, New Jersey","department":"None"},{"first_name":"Pamela","middle_name":"","last_name":"Ohman Strickland","name_suffix":"","institution":"Rutgers School of Public Health, Department of Biostatistics and Epidemiology, Piscataway, New Jersey","department":"None"},{"first_name":"Renee","middle_name":"","last_name":"Riggs","name_suffix":"","institution":"Rutgers Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, New Jersey","department":"None"},{"first_name":"Robert","middle_name":"","last_name":"Eisenstein","name_suffix":"","institution":"Rutgers Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, New Jersey","department":"None"}],"date_submitted":"2021-10-28T19:49:03+02:00","date_accepted":"2021-10-28T19:49:03+02:00","date_published":"2022-08-19T20:53:49+02:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/16068/galley/8061/download/"}]}