Bamlanivimab reduces risk of COVID-19 in nursing homes, study finds
Preventive use of bamlanivimab lowered the risk of symptomatic COVID-19 in staff and residents of skilled nursing and assisted living facilities in the United States, according to a study yesterday in JAMA.
In April, after the study was conducted, the US Food and Drug Administration rescinded emergency use authorization for the monoclonal antibody (mAb) when used alone because of resistance of SARS-CoV-2 variants to the drug. A treatment of bamlanivimab and etesevimab is still allowed.
The researchers enrolled 666 staff and 300 residents with no history of SARS-CoV-2 from Aug 2 to Nov 2, 2020, with half receiving one dose of 4,200 milligrams of bamlanivimab and the other half receiving a placebo. The mean age was 53.0 years, 74.7% were women, and 88.9% were White.
By day 57 post-treatment, the intervention group had significantly less mild or worse COVID-19 infection compared with the placebo group (8.5% vs 15.2% incidence; odds ratio [OR], 0.43), with similar results for moderate or worse COVID-19 (8.3% vs 14.1%; OR, 0.46). Risk reduction increased when stratifying for residents only (8.8% vs 22.5%; OR, 0.20), but it did not have any significant association in staff alone (8.5% vs 12.2%; OR, 0.58).
About one in three people developed COVID-19 (29.3%), but those in the bamlanivimab group had significantly lower viral loads as well as higher viral clearance 3 weeks post-diagnosis (93.0% vs 78.0%).
A safety analysis involving 1,175 people with mixed SARS-CoV-2 history showed adverse events (eg, urinary tract infection) in 20.1% of the intervention group and 18.9% of the control group, with serious events in 3.7% and 3.2%, respectively. Five people died, all in the placebo group.
“It is easy to conceive of situations in which SARS-CoV-2 mAbs might be used to abort outbreaks of COVID-19 in residential facilities similar to how oseltamivir is used to prevent influenza,” writes Daniel R. Kuritzkes, MD, in an editorial. However, he adds, “Given the absence of any clinical trial data on etesevimab alone, the future clinical utility of this combination in the context of spreading SARS-CoV-2 resistance to bamlanivimab is uncertain.”
Jun 3 JAMA study and editorial
H1N1v flu infects Iowa farm worker, 5th variant flu case this year
A human infection involving variant H1N1 (H1N1v) has been reported in an adult in Iowa, marking the third case involving H1N1v and the fifth variant case overall this year, the US Centers for Disease Control and Prevention (CDC) said today in its weekly FluView report.
The investigation revealed that the patient worked on a farm that kept pigs. No other related cases were found. H1N1v cases reported earlier this season were in North Carolina and Wisconsin.
Past infections involving variant types such as H1N1v have been linked to swine exposure, including at agricultural fairs.
Overall, five variant flu cases have been reported this year, the CDC said in a news release. All involved direct or indirect exposure to pigs. Besides the three H1N1v cases, two H1N2v cases were reported, one in Iowa and the other in Ohio. Three were in children, and two involved adults. All patients recovered, and no human-to-human cases were found.
Three countries report more vaccine-derived polio cases
Three countries—two in the Middle East and one in Africa—reported more polio cases this week, all involving circulating vaccine-derived poliovirus type 2 (cVDPV2), the Global Polio Eradication Initiative (GPEI) said today in its weekly update.
Afghanistan reported 1 case, involving a patient from Zabul, raising its cVDPV2 total for the year to 39. Neighboring Pakistan also 1 one case, affecting an individual from Balochistan and lifting its total for 2021 to 8.
In Africa, Nigeria reported 2 cases, 1 each in Jigwa and Kebbi, putting its total at 8 this year so far.
Jun 3 GPEI update