Effect of amubarvimab-romlusevimab for treatment of severe COVID-19 in
intensive care units: a retrospective cohort study
Abstract
Amubarvimab-romlusevimab is used antiviral regimens currently
recommended in China for the treatment of adult patients with mild or
moderate SARS-CoV-2 infections who are at a high risk factor for
progression to severe COVID-19, but its exact efficacy in patients with
severe COVID-19 is not yet known. This is a single-center retrospective
cohort study. A total of 121 patients in intensive care units(ICU)
diagnosed with severe COVID-19 were evaluated.The
amubarvimab-romlusevimab therapy can reduce the 14-day
mortality(23.40% vs 41.89%, p=0.037), 28-day mortality(29.79 % vs
51.35%,p=0.02), and ICU mortality(29.79% vs 55.41%,p=0.006) of
severe COVID-19. To reduce bias and make the two groups balanced and
comparable, a 1:1 PSM was performed. In the matched population(n=47),
there were no statistically significant differences between the mAbs
(monoclonal antibody)group and the Non-antiviral group in 14-day,
28-day, and thromboembolic events in COVID-19 patients. The 40-day
survival analysis shows that mAbs therapy can improve patient prognosis
(HR=0.45, 95%CI=0.26-0.76, p=0.008). However, no significant intergroup
difference in the 40-day cumulative viral conversion rate. In a
univariate Cox regression analysis, The Amubarvimab - romlusevimab
therapy( HR:0.464; CI:[0.252-0.853];p:0.013),CRP, PCT, PLT, Lactate,
PT, PT-INR, and pt% level at admission were risk factors for clinical
prognosis. After including the above covariates, Multifactorial COX
regression shows that the Amubarvimab - romlusevimab therapy( HR:0.464;
CI:[0.252-0.853];p:0.013), CRP, Lactate and PT-INR at admission are
independent factors for mortality of severe COVID-19. Based on the
current data, we conclude that amubarvimab-romlusevimab therapy is
beneficial for patients with severe COVID-19.