Real-World Outcomes of Neutralizing Monoclonal Antibody Treatment in Patients Affected by Nosocomial Coronavirus Disease 2019

Introduction Neutralizing monoclonal antibodies (NmAbs) are a treatment option in patients with early SARS-CoV-2 infection. In this study, we examined the role of NmAbs therapies in a cohort of patients affected by nosocomial COVID-19 infection and high risk of illness progression. Methods A retrospective, single-center analysis was performed including all patients affected by nosocomial SARS-CoV-2 infection receiving NmAbs treatment between April 2021 and March 2022. Results The overall included patients were 75. Mortality rate was 13.3%; disease progression was observed in 22 patients (29.3%); clinical improvement was reported in 49 subjects (65.3%). In multivariate logistic regression, the presence of immunosuppression risk factor and late administration of therapies were recognized as independent predictors of treatment failure. Conclusions In this real-world analysis, the treatment with NmAbs was safety and effectiveness in high-risk patients with nosocomial COVID-19 infection, but the timing of administration and the role of viral variants are the main limiting factors of this approach.