Emergency department implementation of monoclonal antibody infusion for the treatment of coronavirus disease 2019: A template for rapid deployment
Thomas J. Woltemate, Richard J. Wadas, Erin K McCreary, Ryan Bariola, Tami Minnier, Oscar C. Marroquin, Mark Schmidhofer, Debbie Albin, Derek C. Angus, Donald M. Yealy
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.