Mobile units deliver monoclonal antibody infusions for COVID-19 patients in nursing homes

A mobile programme improves infusion rates of monoclonal antibody therapies in nursing home residents at high risk of severe novel coronavirus disease (COVID-19), a new study has found.

Researchers conducted a retrospective analysis of 75 residents of skilled nursing home facilities who were eligible to receive emergency treatment with bamlanivimab and casirivimab-imdevimab.

Because transporting the residents to off-site infusion centres could increase the risk of contracting COVID-19 and aggravate distress secondary to dementia or fragility, the researchers developed a mobile infusion team comprised of registered nurses to administer the antibodies at the nursing facility.

Of the 75 patients referred for infusion, 60 percent (n=45) ultimately received the monoclonal antibodies. Most (n=39; 87 percent) were given casirivimab-imdevimab, while six (13 percent) took bamlanivimab.

Of the 51 nursing facilities included, the mobile unit was able to carry out infusions at eight, serving 2–17 patients at each site. Notably, six facilities were rural, with the farthest being over 80 miles away from the city. The average time to infusion was 4.3 days after COVID-19 diagnosis.

In terms of outcomes, the combined event rate for all-cause death, hospitalization, and emergency department visit was 11.1 percent in the 14 days after infusion. However, no patient was hospitalized due to COVID-19 progression, and there were no deaths.

Two patients needed to be entered into a hospice programme, and one patient developed shortness of breath from congestive heart failure during infusion.

“The logistical challenges of administering monoclonal antibody therapies for the treatment of COVID-19 in frail residents of skilled nursing facilities can be effectively overcome by deploying a multidisciplinary mobile infusion team,” the researchers said.