Emergency department implementation of monoclonal antibody infusion for the treatment of coronavirus disease 2019: A template for rapid deployment

J Am Coll Emerg Physicians Open. 2021 Sep 17;2(5):e12550. doi: 10.1002/emp2.12550. eCollection 2021 Oct.

Abstract

Monoclonal antibody (mAb) therapy can improve coronavirus disease 2019 outcomes when infused early in select patients. We sought to rapidly create and implement a program for emergency department (ED) mAb infusion to aid care. Using multiple strategies and actions-education, selection criteria, screening tools, rapid testing, compounding, and delivery-we infused 832 ED patients with a mAb. The screening tool identified 94.5% of these patients as potential candidates. Length of stay was nearly identical for patients who tested positive for coronavirus disease 2019 versus those requiring testing. Mild adverse reactions occurred in 2.3% of mAb infusions, and severe reactions occurred in 0.5% of infusions. We highlight a strategic approach for using the ED as a key coronavirus disease 2019 therapeutic site for this intervention and with high utility and low disruption.

Keywords: casirivimab; coronavirus disease 2019; emergency department; etesevimab; imdevimab; monoclonal antibodies; severe acute respiratory syndrome coronavirus 2.