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Vaginal delivery after improvement in COVID-19 by monoclonal antibody treatment: A case report and literature review.

ABSTRACT: As the COVID-19 pandemic persists, pregnant women have been increasingly affected worldwide. Women during the last trimester of pregnancy are susceptible to severe COVID-19, and there are many challenges towards its treatment. Monoclonal antibody treatment (MAT) is approved for COVID-19 patients to reduce disease severity. However, there are few reports on the MAT in perinatal women. Herein, we report a 39-year-old pregnant female (36 weeks and 6 days of gestation) with improvement in COVID-19 pneumonia after treatment with casiribimab/imdevimab, resulting in successful vaginal delivery (a 2.868 kg male newborn), along with a literature review. Early diagnosis and treatment of pregnant women with COVID-19 are important. Infectious diseases doctors and/or obstetricians should be aware of the MAT option administered to perinatal COVID-19 women to reduce disease severity.

SUBMITTER: Ogawa E

PROVIDER: S-EPMC8898669 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Vaginal delivery after improvement in COVID-19 by monoclonal antibody treatment: A case report and literature review.

Ogawa Eisuke E Goto Hirohisa H Ushimaru Hiroyasu H Matsuo Akemi A Takeda Satoshi S Nishimura Ryohei R Hondo Takaaki T Takahashi Takashi T

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 20220307 7

As the COVID-19 pandemic persists, pregnant women have been increasingly affected worldwide. Women during the last trimester of pregnancy are susceptible to severe COVID-19, and there are many challenges towards its treatment. Monoclonal antibody treatment (MAT) is approved for COVID-19 patients to reduce disease severity. However, there are few reports on the MAT in perinatal women. Herein, we report a 39-year-old pregnant female (36 weeks and 6 days of gestation) with improvement in COVID-19 p ...[more]

PMID: 35288022

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Project description:BackgroundDisparities in access to anti-SARS-CoV-2 monoclonal antibodies have not been well characterized.ObjectiveWe sought to explore the impact of race/ethnicity as a social construct on monoclonal antibody delivery.Design/patientsFollowing implementation of a centralized infusion program at a large academic healthcare system, we reviewed a random sample of high-risk ambulatory adult patients with COVID-19 referred for monoclonal antibody therapy.Main measuresWe examined the relationship between treatment delivery, race/ethnicity, and other demographics using descriptive statistics, binary logistic regression, and spatial analysis.Key resultsThere was no significant difference in racial composition between patients who did (n = 25) and patients who did not (n = 378) decline treatment (p = 0.638). Of patients who did not decline treatment, 64.8% identified as White, 14.8% as Hispanic/Latinx, and 11.1% as Black. Only 44.6% of Hispanic/Latinx and 31.0% of Black patients received treatment compared to 64.1% of White patients (OR 0.45, 95% CI 0.25-0.81, p = 0.008, and OR 0.25, 95% CI 0.12-0.50, p < 0.001, respectively). In multivariable analysis including age, race, insurance status, non-English primary language, county Social Vulnerability Index, illness severity, and total number of comorbidities, associations between receiving treatment and Hispanic/Latinx or Black race were no longer statistically significant (AOR 1.32, 95% CI 0.69-2.53, p = 0.400, and AOR 1.34, 95% CI 0.64-2.80, p = 0.439, respectively). However, patients who were uninsured or whose primary language was not English were less likely to receive treatment (AOR 0.16, 95% CI 0.03-0.88, p = 0.035, and AOR 0.37, 95% CI 0.15-0.90, p = 0.028, respectively). Spatial analysis suggested decreased monoclonal antibody delivery to Cook County patients residing in socially vulnerable communities.ConclusionsHigh-risk ambulatory patients with COVID-19 who identified as Hispanic/Latinx or Black were less likely to receive monoclonal antibody therapy in univariate analysis, a finding not explained by patient refusal. Multivariable and spatial analyses suggested insurance status, language, and social vulnerability contributed to racial disparities.

Dataset Information

Vaginal delivery after improvement in COVID-19 by monoclonal antibody treatment: A case report and literature review.

Publications

Vaginal delivery after improvement in COVID-19 by monoclonal antibody treatment: A case report and literature review.

Similar Datasets

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