Health

Monoclonal antibody treatment is effective for high-risk Native American COVID-19 patients


Monoclonal antibodies may be a crucial treatment for high-risk Native Americans who contract COVID-19, a new study suggests.

Researchers from the Whiteriver Service Unit, a healthcare facility on the Fort Apache Indian Reservation, found that no patients who received monoclonal antibodies required intensive care or died from the disease.

The patients treated with monoclonal antibodies were also less likely to require hospitalization or a transfer to a secondary medical facility.

The findings show that this treatment – which boosts vulnerable patients’ immune systems – is effective for Native Americans, a group that’s been hard-hit by Covid in the U.S.

Monoclonal antibodies may be an effective treatment for reducing COVID-19's severity in high-risk, Native American patients, a new study shows. Pictured: A patient is taken from the ambulance to the emergency room in Navajo Nation, Arizona, May 2020

Monoclonal antibodies may be an effective treatment for reducing COVID-19’s severity in high-risk, Native American patients, a new study shows. Pictured: A patient is taken from the ambulance to the emergency room in Navajo Nation, Arizona, May 2020

Indigenous Americans are more likely to die of Covid than other demographic groups in the U.S., according to APM Research Lab

Indigenous Americans are more likely to die of Covid than other demographic groups in the U.S., according to APM Research Lab

Monoclonal antibodies are a common treatment for Covid patients, especially for those deemed at high risk for severe symptoms.

It works by delivering an infusion of lab-made immune system proteins that are designed specifically to fight the coronavirus.

For many patients, the treatment can prevent a case from becoming severe enough that a patient requires hospital care.

However, previous studies of this treatment have not included Native Americans – who are highly vulnerable to severe Covid cases, data show.

Native Americans and Alaska Natives are 3.3 times more likely to have died of Covid than white Americans during the first year of the pandemic, according to an analysis by APM Research Lab.

Data from the Centers for Disease Control and Prevention (CDC) show a similar pattern.

Indigenous Americans have consistently had high death rates through different phases of the pandemic, with a peak of 9.2 deaths for every 100,000 people during one week in December 2020.

As a result, clinicians working at the Fort Apache Indian Reservation in Arizona saw the need for a study that evaluated how well monoclonal antibody treatments work for this vulnerable population.

The study – published on Tuesday in JAMA Network Open – focused on high-risk Native American patients at the Whiteriver Service Unit, the primary hospital and public health department on this reservation.

Between December 2020 and February 2021, the healthcare facility treated a total of 983 patients who had received a positive Covid test.

Clinicians screened these patients to evaluate whether they were eligible for monoclonal antibody treatment.

Eligible patients were older, had higher body mass index (BMI), and had other preexisting conditions increasing their risk for severe Covid.

A total of 481 patients met the criteria for monoclonal antibody treatment. Of those, 201 patients decided to receive the treatment.

Native Americans and Alaska Natives (yellow line) have consistently had higher death rates than other groups throughout the pandemic, CDC data show

Native Americans and Alaska Natives (yellow line) have consistently had higher death rates than other groups throughout the pandemic, CDC data show

The patients who received this immune system-boosting treatment fared much better than those who didn’t, the researchers found.

Monoclonal antibody patients were less likely to require an acute medical visit with 29 percent of these patients visiting compared to 49 percent of patients who didn’t receive the treatment.

Monoclonal antibody patients were also less likely to require hospitalization (17 percent compared to 43 percent of non-monoclonal antibody patients) or require a transfer to an outside facility for more high-level care (two percent compared to nine percent).

In addition, none of the patients who received monoclonal antibody treatments were admitted to the ICU or died of Covid.

Eight patients died during the study period – all of whom met the criteria for monoclonal antibodies, but did not receive this treatment.

This study’s findings align with other research showing how monoclonal antibodies may prevent Covid cases from becoming severe.

But this research specifically shows that the treatment works well for high-risk Native Americans, a group that was not previously studied.

Researchers found that monoclonal antibody treatments worked well for patients at Whiteriver Service Unit, a healthcare facility on the Fort Apache Indian Reservation in Arizona. Pictured: Whiteriver Indian Hospital, part of the facility

Researchers found that monoclonal antibody treatments worked well for patients at Whiteriver Service Unit, a healthcare facility on the Fort Apache Indian Reservation in Arizona. Pictured: Whiteriver Indian Hospital, part of the facility

The authors noted that one driver of the Whiteriver Service Unit’s success may be that patients were able to receive monoclonal antibody treatment fairly early into their bout with Covid – boosting their immune systems at the ideal time to prevent severe symptoms.

The median patient who received monoclonal antibodies did so within one day of their positive Covid test, and within two days of experiencing symptoms.

Most patients – over 75 percent – were treated within three days of their symptoms starting.

‘The WRSU decreased the time to treatment by integrating contact tracing, clinical outreach, in-house molecular testing, and a unified public health and hospital system that streamlined information exchange,’ the study’s authors wrote.

‘This approach may not be generalizable but is a model for other centralized health systems.’

The authors also noted that monoclonal antibodies ‘can be used to great effect in rural, relatively resource-limited settings.’



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