Monoclonal antibodies show promise for improved outcomes for COVID-19 patients, but when hospitalization is already above capacity, administration of them can be challenging. As hospitals across California grew, clinicians with UCI Health created a system for delivering monoclonal antibodies that keep hospital beds available for patients with the greatest need.
One of our most valuable facilities is the hospital bed, which has been stretched thinly by the COVID-19 pandemic. Every effort to increase the number of beds available counts, and that includes being proactive in banning hospitals. “
Dr. Daniel S. Chow, Associate Professor, Residency, Radical Sciences, Associate Director, Center for Artificial Science, Diagnostic Medicine
They are partners with the federal government’s response to COVID-19 to share the success in delivering monoclonal antibodies to health care systems across the country.
Despite the increasing availability of COVID-19 vaccines, there is still an urgent need to identify, develop and expand the use of medications for those with the disease. The FDA approved emergency use for Eli Lilly and Regeneron monoclonal antibodies in November. The treatment – which uses laboratory-made proteins to prevent the virus from entering human cells – is authorized for moderate to mild COVID-19 cases in adults and some of pediatric patients who are at high risk of developing severe symptoms or who may require hospitalization.
However, according to NPR and other news sources, health care systems have been slow to adopt this treatment because of the measures involved in administering it. The infusion treatment requires an hour, followed by an hour of observation before patients are discharged to self-examination at home.
In early February, UCI Health had treated approximately 170 patients with monoclonal antibody therapy and severe hospitalization due to severe cases of COVID-19.
As hospitals across the country reach and exceed their capacity to accommodate patients because of COVID-19, it is vital that we use every facility to ease the burden on the patient. reduce the health care system. When monoclonal therapies are given appropriately, they have the potential to reduce disease progression and the need for hospitalization, so we are thrilled to see success stories like UCI. “
Since the treatment is only given to patients who have tested positive for COVID-19, the establishment must be separated from other patients so that they do not spread the infection. With hospitals at or near full capacity, it is a challenge to allocate health care workers and a safe, designated infusion space.
UCI Health has created a successful system for doing this. They set aside six chairs with dedicated staff in an infusion clinic that allows patients to get in and out of a closed loop system that avoids putting non-COVID patients at risk. Patients who respond to the emergency use consent guideline are referred to the clinic through their physicians when they test positive for COVID-19. The clinic is able to treat 24 to 36 patients with monoclonal antibodies daily.
Using AI technology to help with therapies
UCI is also investigating whether the existing machine learning tool – designed to predict the likelihood of a COVID-19 patient needing an ICU shower or bed – can also help potential patients benefit from monoclonal antibody treatment. The researchers incorporate EUA guidelines into the model.
“In conjunction with EUA recommendations, our tool may help us stratify and identify additional patients who may benefit from monoclonal antibodies,” Chow said.
Of the first 86 patients who received monoclonal antibody treatment at UCI – which included Latino, white, Asian-American, and Black patients – only about 3 percent were subsequently admitted. to the emergency department. This follows the FDA’s findings that only about 3 percent of high-risk patients treated with the treatment required a visit to a hospital or emergency department, compared to 9 percent of patients. patients in the control group.
“If we can avoid symbolic and COVID-positive mobile patients from ever touching our emergency department or hospital setting, that will help the community and regulate bed flow,” he said. Dr. Alpesh N. Amin, Thomas & Mary Cesario Chair of Medicine and principal investigator of the project.
“The average hospital stay for a COVID patient at UCI is just over seven days,” Chow said. “So this is definitely a big impact, especially when you consider the related needs for each hospital day, including the needs of nurses and staff at a time when staff are stretched thin, as well as related medical supplies, etc. “
Using the federal response circulation network, UCI Health shares their monoclonal antibody delivery system with other health care systems. Interested hospitals can reach out to Amin for a consultation.
“Vaccines give us all hope that the end of pandemic is near, but monoclonal antibodies give us ‘more than hope’ because we can now treat high-risk patients with COVID-19 treatment and reduce the risk of hospitalization, “said Col. Deydre Teyhen, deputy manager of the federal government ‘s therapeutic response program.
Source:
University of California – Irvine