Resolution Consensus Statement. Neutralizing monoclonal antibodies for treatment of COVID-19 – a role in the treatment of vulnerable categories of patients

Authors / Institutions

Vladimir P. Chulanov / National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russian Federation / I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation

Roman G. Shmakov / V.I.Kulakov Scientific Center of Obstetrics, Gynecology and Perinatology Ministry of Public Health of the Russian Federation, Moscow, Russian Federation

Dmitriy A. Lioznov / Academician I.P.Pavlov First Saint Petersburg State Medical University, St.Petersburg, Russian Federation / A.A.Smorodintsev Research Institute of Influenza, St.Petersburg, Russian Federation

Diana I. Abdulganieva / Kazan State Medical University, Kazan, Russian Federation

Damir А. Valishin / Bashkir State Medical University, Ufa, Russian Federation

Marina R. Ivanova /

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Lyudmila L. Katanakhova / Kh.M.Berbekov Kabardino-Balkararian State University , Nalchik, Russian Federation

Pavel L. Kuznetsov / Surgut State University, Khanty–Mansi Autonomous Area–Yugra, Surgut, Russian Federation / Surgut Regional Clinical Hospital, Surgut, Russian Federation

Zinaida Yu. Mutovina / Urals State Medical University, Ekaterinburg, Russian Federation

Olga V. Polikarpova / City Clinical Hospital No 52, Moscow Department of Health, Moscow, Russian Federation / Central State Medical Academy of the office of the President of the Russian Federation, Moscow, Russian Federation

Olga I. Sagalova / City Clinical Hospital No 52, Moscow Department of Health, Moscow, Russian Federation

Svetlana V. Smetanina / South-Urals State Medical University, Chelyabinsk, Russian Federation

Khalit S. Khaertynov / Clinical Hospital Infectious Diseases No 1, Moscow Healthcare Department, Moscow, Russian Federation

/ Kazan State Medical University, Kazan, Russian Federation

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
For citation: Chulanov V.P., Shmakov R.G., Lioznov D.A., Abdulganieva D.I., Valishin D.A., Grabovsky V.M., Ivanova M.R., Katanakhova L.L., Kuznetsov P.L., Mutovina Z.Yu., Polikarpova O.V., Sagalova O.I., Smetanina S.V., Khaertynov Kh.S. Resolution Consensus Statement. Neutralizing monoclonal antibodies for treatment of COVID-19 – a role in the treatment of vulnerable categories of patients. Infekc. bolezni (Infectious Diseases). 2023; 21(1): 152–161. (In Russian). DOI: 10.20953/1729-9225-2023-1-152-161