Am J Perinatol
DOI: 10.1055/a-1925-2017
Short Communication

Casirivimab and Imdevimab for Pregnant Women Hospitalized for Severe Coronavirus Disease 2019

Buonomo A. Riccardo
1   Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II Naples, Naples, Italy
,
Saccone Gabriele
2   Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
,
Esposito Nunzia
2   Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
,
Di Filippo Isabella
1   Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II Naples, Naples, Italy
,
Pinchera Biagio
1   Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II Naples, Naples, Italy
,
Foggia Maria
1   Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II Naples, Naples, Italy
,
Zappulo Emanuela
1   Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II Naples, Naples, Italy
,
Giaccone Agnese
1   Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II Naples, Naples, Italy
,
Schiano M. Nicola
1   Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II Naples, Naples, Italy
,
Viceconte Giulio
1   Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II Naples, Naples, Italy
,
Scotto Riccardo
1   Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II Naples, Naples, Italy
,
Bifulco Giuseppe
2   Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
,
Gentile Ivan
1   Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II Naples, Naples, Italy
› Author Affiliations
Funding None.

Abstract

Objective Our objective was to evaluate the safety and efficacy of casirivimab/imdevimab therapy in pregnant women with severe coronavirus disease 2019 (COVID-19) requiring oxygen therapy.

Study Design This was a prospective case series study aimed to evaluate the safety and efficacy of casirivimab/imdevimab therapy in unvaccinated pregnant women with severe COVID-19. Inclusion criteria were severe acute respiratory syndrome coronavirus 2 infection documented with polymerase chain reaction, pregnancy, severe COVID-19 requiring oxygen therapy, duration of symptoms of 10 days or less, and able to provide informed consent. Vaccinated women and those with mild-to-moderate disease were excluded from the study. Included patients received casirivimab and imdevimab as a single intravenous dose of 4,000/4,000 mg. Women were also treated with low molecular weight heparin, steroids, and antibiotics, if necessary. The primary outcome was maternal death. Secondary outcomes were the rate of adverse events during infusion or within 72 hours and the rate of abortion.

Results Thirteen hospitalized unvaccinated pregnant women with severe COVID-19 requiring oxygen and treated with casirivimab/imdevimab were included in the study. We observed no maternal death, and no patients required intubation or admission to the intensive care unit. No abortion or fetal loss was recorded. Nine pregnancies were still ongoing, and there were three cesarean deliveries and one vaginal delivery. Two were preterm deliveries (at 31 and 34 weeks), and two were term deliveries.

Conclusion Casirivimab/imdevimab therapy may be considered as a therapy in unvaccinated pregnant women with severe COVID-19.



Publication History

Received: 05 March 2022

Accepted: 11 August 2022

Accepted Manuscript online:
16 August 2022

Article published online:
29 December 2022

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