Emergency department implementation of monoclonal antibody infusion for the treatment of coronavirus disease 2019: A template for rapid deployment

Abstract

Abstract Monoclonal antibody (mAb) therapy can improve coronavirus disease 2019 outcomes when infused early in select patients. We sought to rapidly create and implement a program for emergency department (ED) mAb infusion to aid care. Using multiple strategies and actions—education, selection criteria, screening tools, rapid testing, compounding, and delivery—we infused 832 ED patients with a mAb. The screening tool identified 94.5% of these patients as potential candidates. Length of stay was nearly identical for patients who tested positive for coronavirus disease 2019 versus those requiring testing. Mild adverse reactions occurred in 2.3% of mAb infusions, and severe reactions occurred in 0.5% of infusions. We highlight a strategic approach for using the ED as a key coronavirus disease 2019 therapeutic site for this intervention and with high utility and low disruption.

Keywords

• casirivimab
• coronavirus disease 2019
• emergency department
• etesevimab
• imdevimab
• monoclonal antibodies