Original Articles
Vol. 14 No. 1 (2022): Review Articles, Original Article, Scientific Letter, Case Reports Letter to the Editor
https://doi.org/10.4084/MJHID.2022.050

PRE AND POST-MONOCLONAL INFUSION NEUTRALIZING ACTIVITY IN A SUBGROUP OF PATIENTS TREATED IN THE PRESENCE OF TWO SARS-COV-2 DOMINANT VARIANT OF CONCERN (VOCS) AND AN ONGOING VACCINATION. OVERALL CLINICAL EFFICACY OF TWO MONOCLONAL ANTIBODIES ASSOCIATION IN UMBRIA

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Received: February 9, 2022
Accepted: May 18, 2022
Published: June 29, 2022
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COVID19, mAbs, VOCs, neutralizing activity

Authors

Elisabetta Schiaroli
elisabetta.schiaroli@unipg.it
Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy, Italy.
Giuseppe Vittorio De Socio
Unit of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy, Italy.
Anna Gidari
Unit of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Santa Maria Hospital of Terni ,Terni , Italy, Italy.
Lisa Malincarne
Unit of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy, Italy.
Sara Benedetti
Unit of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy, Italy.
Alessandra Lanzi
Unit of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy, Italy.
Sabrina Bastianelli
Unit of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy, Italy.
Sara Pierucci
Unit of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy, Italy.
Chiara busti
Unit of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy, Italy.
Daniela Francisci
Unit of Infectious Diseases, Department of Medicine and Surgery, University of Perugia, Perugia, Italy, Italy.

Background and Objective: In patients with mild-to-moderate COVID-19 and at high risk of progression, casirivimab/imdevimab and bamlanivimab/etesivimab were utilized in Umbria from late April to November 2021. This period was characterized by an initial prevalence of alpha (B1.1.1.7) and its progressive substitution with the delta variant (B1.617.2). Many delta infections occurred in patients already recently vaccinated.

Our study aimed to observe the clinical outcome of patients treated with mAbs associations in a subgroup in which viral isolation was obtained, the pre and post-infusion neutralizing antibody activity against their viral isolate.

Methods: In this retrospective observational study, the clinical outcome before and 30 days after infusion, the baseline neutralizing activity of sera against their viral isolate, and the titers of neutralizing antibodies (NAbTs) one-hour post-infusion relative to the type of mAbs associations were evaluated.

Results: Better efficacy of the mAbs combinations relative to monotherapy regarding global hospitalization (p = 0.021) and 30 days symptoms (p<0.001) were seen. Infections after vaccination mostly occurred in the absence of neutralizing antibody titers (NAbT). SARS-CoV-2 delta variants were isolated within 2-4 months from vaccinations without NAbTs, or in the presence of high specific neutralizing activity after 5-6 months. NAbTs were higher after casirivimab/imdevimab infusion (p=0.001).

Conclusions: Alpha infections occurred prevalently in unvaccinated patients or after 5-6 months, while delta infections prevailed in vaccinated ones. A poor neutralizing activity in most of these patients was seen. A higher NAbT after infusion of casirivimab/imdevimab was observed.

 

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Supporting Agencies

This research was funded by FONDAZIONE CASSA DI RISPARMIO DI PERUGIA. grant number 19663(2020.05.08)

How to Cite



“PRE AND POST-MONOCLONAL INFUSION NEUTRALIZING ACTIVITY IN A SUBGROUP OF PATIENTS TREATED IN THE PRESENCE OF TWO SARS-COV-2 DOMINANT VARIANT OF CONCERN (VOCS) AND AN ONGOING VACCINATION. OVERALL CLINICAL EFFICACY OF TWO MONOCLONAL ANTIBODIES ASSOCIATION IN UMBRIA” (2022) Mediterranean Journal of Hematology and Infectious Diseases, 14(1), p. e2022050. doi:10.4084/MJHID.2022.050.
Copyright (c) 2022 Elisabetta Schiaroli, Giuseppe Vittorio De Socio, Anna Gidari, Lisa Malincarne, Sara Benedetti , Alessandra Lanzi, Sabrina Bastianelli, Sara Pierucci, Chiara busti, Daniela Francisci Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.