PDF(Pubmed)
Abstract：
While medical countermeasures in COVID-19 have largely focused on vaccinations, monoclonal antibodies (mAbs) were early outpatient treatment options for COVID-positive patients. In Minnesota, a centralized access platform was developed to offer access to mAbs that linked over 31,000 patients to care during its operation. The website allowed patients, their representative, or providers to screen the patient for mAbs against Emergency Use Authorization (EUA) criteria and connect them with a treatment site if provisionally eligible. A validated clinical risk scoring system was used to prioritize patients during times of scarcity. Both an ethics and a clinical subject matter expert group advised the Minnesota Department of Health on equitable approaches to distribution across a range of situations as the pandemic evolved. This case study outlines the implementation of this online platform and clinical outcomes of its users. We assess the impact of referral for mAbs on hospitalizations and death during a period of scarcity, finding in particular that vaccination conferred a substantially larger protection against hospitalization than a referral for mAbs, but among unvaccinated users that did not get a referral, chances of hospitalization increased by 4.1 percentage points.
摘要：
虽然COVID-19的医疗对策主要集中在疫苗接种上，单克隆抗体（mAb）是COVID阳性患者的早期门诊治疗选择。在明尼苏达,开发了一个集中式访问平台，以提供对单克隆抗体的访问，该单克隆抗体在手术期间将超过31,000名患者与护理联系起来。该网站允许患者，他们的代表,或提供者根据紧急使用授权(EUA)标准对患者进行单克隆抗体筛查,并在暂时符合条件的情况下将其与治疗地点连接。经过验证的临床风险评分系统用于在稀缺时期对患者进行优先级排序。随着大流行的发展，伦理学和临床主题专家组都向明尼苏达州卫生部提供了关于在各种情况下进行分配的公平方法的建议。本案例研究概述了该在线平台的实施及其用户的临床结果。我们评估了MAB转诊对稀缺期间住院和死亡的影响，特别是发现接种疫苗比转诊单克隆抗体具有更大的住院保护作用，但是在没有得到推荐的未接种疫苗的用户中，住院机会增加了4.1个百分点。
