Neutralizing monoclonal antibodies for treatment of COVID-19 – a role in the treatment of vulnerable categories of patients
Authors:   National Medical Research Center of Tuberculosis and Infectious Diseases, Moscow, Russian Federation, Chulanov V.P. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Shmakov R.G. ,   V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation, Lioznov D.A. ,   A.A.Smorodintsev Research Institute of Influenza, Saint Petersburg, Russian Federation,   I.P.Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russian Federation, Abdulganieva D.I. ,   Kazan State Medical University, Kazan, Russian Federation, Valishin D.A. ,   Bashkir State Medical University, Ufa, Russian Federation, Grabovsky V.M. ,   City Clinical Hospital No 52 of the Moscow Department of Health, Moscow, Russian Federation, Ivanova M.R. ,   Center for the Prevention and Control of AIDS and Infectious Diseases of the Ministry of Health of the Kabardino-Balkarian Republic, Nalchik, Russian Federation, Katanakhova L.L. ,   Surgut Regional Clinical Hospital, Surgut, Russian Federation, Kuznetsov P.L. ,   City Clinical Hospital No 40, Ural State Medical University, Yekaterinburg, Russian Federation, Mutovina Z.Yu. ,   City Clinical Hospital No 52 of the Moscow Department of Health, Moscow, Russian Federation, Polikarpova O.V. ,   City Clinical Hospital No 52 of the Moscow Department of Health, Moscow, Russian Federation, Sagalova O.I. ,   South Ural State Medical University, Chelyabinsk, Russian Federation, Smetanina S.V. ,   V.P.Demikhov City Clinical Hospital, Moscow, Russian Federation, Khaertynov Kh.S. ,   Kazan State Medical University, Kazan, Russian Federation
Published: March 2024

In December 2022, the Council of Experts was held. It purpose was to determine the place of virus-neutralizing monoclonal antibodies (NMA) in the ethiotropic treatment of COVID-19 in vulnerable categories of patients. The main issues were identified and their solutions were proposed. At the first visit of pregnant women due to COVID-19, proactive identification of risk factors and early prescription of NMA are recommended, preferably – with published safety data in this category of patients (casirivimab + imdevimab). In patients with oncological and other chronic (rheumatology, pulmonology, gastroenterology) diseases, prophylactic use of NMA is recommended. regardless of the severity of the disease. For patients with chronic pathology regardless of the severity of the disease an early prescription of ethiotropic therapy must be provided, combating the long-term circulation of the virus. To solve the problem of late treatment prescription, it is necessary to: use rapid tests, prescribe NMA if indicated, even if the patient presents late, introduce digital technologies to transfer information about COVID-19 cases between healthcare institutions (HI), create call centers for primary triage of patients, daily hospitals to reduce the burden on the HI. The issue of NMA using related to changes in their activity against new variants of SARS-CoV-2 remains relevant. Among the proposed solutions are: priority of indications over information about the activity of NMA, the diversification of the choice of NMA in HI, taking into account clinical experience, indications for use and prognosis of NMA activity, the use of combined forms of NMA (for example, casirivimab + imdevimab) or a combination of NMA with other means of ethiotropic therapy. Key words: COVID-19, casirivimab/imdevimab, monoclonal antibodies, daily hospitals