Outpatient Use of Monoclonal Antibodies Casirivimab and Imdevimab in Pregnancy for Mild-to-Moderate Coronavirus Disease 2019

Abstract

Objective The aim of this study was to report the use casirivimab/imdevimab therapy in pregnant women with moderate coronavirus disease 2019 (COVID-19).

Study Design We report 12 cases of unvaccinated pregnant patients with mild-to-moderate COVID-19 treated with casirivimab/imdevimab.

Results Twelve unvaccinated pregnant patients with mild-to-moderate COVID-19 received casirivimab/imdevimab at the dose of 1200/1200 mg by intravenous infusion over 60 minutes. All women were managed outpatient. None experienced severe adverse drug reaction and none progressed to severe disease.

Conclusion Casirivimab/imdevimab should be considered for outpatient treatment of unvaccinated pregnant women with mild-to-moderate COVID-19 to decrease the risk of severe disease.

Key Points

• Casirivimab/imdevimab is not well studied in pregnant women.

• Casirivimab/imdevimab in pregnant women with mild-to-moderate COVID-19 decreases the risk of severe disease.

• Casirivimab/imdevimab in pregnant women with mild-to-moderate COVID-19 is well tolerated.

Keywords

COVID-19 - infection - NICU - preterm birth

Publication History

Received: 21 January 2022

Accepted: 03 June 2022

Article published online:
18 April 2023

• References

• 1 Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA 2020; 324 (08) 782-793
• 2 Di Mascio D, Buca D, Berghella V. et al. Counseling in maternal-fetal medicine: SARS-CoV-2 infection in pregnancy. Ultrasound Obstet Gynecol 2021; 57 (05) 687-697
• 3 D'Antonio F, Sen C, Mascio DD. et al. On the behalf of the World Association of Perinatal Medicine working group on coronavirus disease 2019. Maternal and perinatal outcomes in high compared to low risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection (phase 2): the World Association of Perinatal Medicine working group on coronavirus disease 2019. Am J Obstet Gynecol MFM 2021; 3 (04) 100329
• 4 WAPM (World Association of Perinatal Medicine) Working Group on COVID-19. Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection. Ultrasound Obstet Gynecol 2021; 57 (02) 232-241
• 5 Boelig RC, Saccone G, Bellussi F, Berghella V. MFM guidance for COVID-19. Am J Obstet Gynecol MFM 2020; 2 (02) 100106
• 6 United States Food and Drug Administration. Fact sheet for health care providers. Emergency use authorization (EUA) of REGEN-COV (casirivimab and imdevimab). Accessed June 30, 2022 at: https://www.fda.gov/media/145611/download
• 7 Gentile I, Maraolo AE, Buonomo AR. et al. Monoclonal antibodies against SARS-CoV-2: potential game-changer still underused. Int J Environ Res Public Health 2021; 18 (21) 11159
• 8 Mayer C, VanHise K, Caskey R, Naqvi M, Burwick RM. Monoclonal antibodies casirivimab and imdevimab in pregnancy for coronavirus disease 2019 (COVID-19). Obstet Gynecol 2021; 138 (06) 937-939