Combination Treatment Effective in Managing COVID-19, Incident Diabetes Associated With Infection, and More

Combination of Amubarvimab, Romlusevimab Effective in Managing Virus¹

In a recent study, researchers sought to determine the efficacy and safety of amubarvimab plus romlusevimab as a COVID-19 therapeutic. Both amubarvimab and romlusevimab are noncompeting anti-COVID-19 monoclonal antibodies.

A randomized, placebo-controlled, phase 2 and 3 platform trial was conducted throughout various countries, including the United Sates. Adults within 10 days of symptom onset of COVID-19 infection who were at high risk for worsening of the disease were participants in the study (n = 807). Patients in the study had a median onset symptom of 6 days.

Researchers found that hospitalizations and/or death occurred in 9 (2.3%) participants who received amubarvimab plus romlusevimab, and 44 (10.7%) in the group that received placebo. Further, there were less frequent emergent adverse events through day 28 observed in the amubarvimab plus romlusevimab group (7.3%) than in the placebo group (16.1%). There were no severe infusion reactions or drug-related serious adverse events.

“Amubarvimab plus romlusevimab was safe and significantly reduced the risk for hospitalization and/or death among nonhospitalized adults with mild to moderate SARS-CoV-2 infection at high risk for progression to severe disease,” the researchers concluded.

The researchers noted that the study’s population was limited to patients who were mostly unvaccinated against the virus and enrolled before the spread of the omicron variants and subvariants.

COVID-19 Infection’s Association With Incident Diabetes²

People who become infected with COVID-19 have a higher risk of developing diabetes, according to a recent cohort study.

A team of researchers conducted a population-based cohort study that evaluated the data of 629,935 individuals who tested for COVID-19—with either a positive or negative result. The primary outcome of their study was “incident diabetes (insulin dependent or not insulin dependent)” that was identified more than 30 days after their COVID-19 test.

Of the total, 125,987 individuals were exposed to COVID-19 and 503,948 individuals were unexposed to the virus. During the median follow-up of 257 days, incident diabetes events were observed among 608 (0.5%) individuals who were exposed to COVID-19 and 1864 individuals who were not exposed (0.4%).

Further, the risk of a person developing diabetes was higher among those with a severe case of infection vs those without COVID-19. This included people admitted to the intensive care unit or hospital for COVID-19 infection.

“These results suggest that infection with SARS-CoV-2 may have contributed to a 3% to 5% excess burden of diabetes, which may be associated with a substantial number of diabetes cases with bearing on health care needs for the management of diabetes and its complications,” the researchers concluded. “Our study highlights the importance of health agencies and clinicians being aware of the potential long-term consequences of COVID-19 and monitoring people after COVID-19 infection for new-onset diabetes for timely diagnosis and treatment.”

Relationship Between COVID-19 Testing Nursing Home Staff and Residents³

Greater surveillance testing of nursing home facility staff members is associated with a reduction in COVID-19 cases and deaths among residents, according to a retrospective cohort study.

Using data from 2020 to 2022, the researchers evaluated COVID-19 test results from 13,424 staff members in skilled nursing facilities over the course of three pandemic periods: (1) before vaccine approval, (2) before the omicron variant wave, (3) during the omicron wave.

During the overall study period, 519.7 cases per 100 potential outbreaks of COVID-19 were reported among residents of high-testing facilities, compared with 591.2 cases among residents of low-testing facilities. In the high-testing facilities, 42.7 deaths per 100 potential outbreaks were reported, compared with 49.8 deaths in low-testing facilities.

Further, before vaccines were available, high-testing facilities reported 759.9 cases and low-testing facilities reported 1060.2 cases, along with 125.2 and 166.8 deaths per 100 potential outbreaks, respectively. High- and low-testing facilities had the same number of cases and deaths before the omicron wave, and high-testing facilities had fewer cases among residents, but the number of deaths were similar in both groups.

“We found that higher rates of surveillance testing of staff in [United States] skilled nursing facilities were associated with fewer resident COVID-19 cases and deaths regardless of testing method (point-of-care [POC] or non-POC),” the researchers concluded. “These effects were most pronounced during the prevaccine time period and among facilities with faster turnaround times for non-POC testing.”

References:

1. Evering TH, Chew KW, Giganti MJ, et al. Safety and efficacy of combination SARS-CoV-2 neutralizing monoclonal antibodies amubarvimab plus romlusevimab in nonhospitalized patients with COVID-19. Ann Intern Med. Published online April 18, 2023. doi:10.7326/M22-3428
2. Naveed Z, Velásquez García HA, Wong S, et al. Association of COVID-19 infection with incident diabetes. JAMA Netw Open. 2023;6(4):e238866. doi:10.1001/jamanetworkopen.2023.8866
3. McGarry BE, Gandhi AD, Barnett ML. COVID-19 surveillance testing and resident outcomes in nursing homes. N Engl J Med. 2023;388:1101-1110. doi:10.1056/NEJMoa2210063