Publications by authors named "M Teresa Seville"

47 Publications

Real-World Clinical Outcomes of Bamlanivimab and Casirivimab-Imdevimab among High-Risk Patients with Mild to Moderate Coronavirus Disease 2019.

J Infect Dis 2021 Jul 19. Epub 2021 Jul 19.

Mayo Clinic, Rochester, Minnesota, USA.

Background: Bamlanivimab and casirivimab-imdevimab are authorized for treatment of high-risk patients with mild to moderate coronavirus disease-2019 (COVID-19). We compared the outcomes of patients who received these therapies to identify factors associated with hospitalization and other clinical outcomes.

Methods: Adult patients who received monoclonal antibody from November 19, 2020 to February 11, 2021 were selected and divided into those who received bamlanivimab (n=2747) and casirivimab-imdevimab (n=849). The 28-day all-cause and COVID-19-related hospitalizations were compared between the groups.

Results: The population included 3596 patients; median age was 62 years; and 50% were female. All had ≥1 medical comorbidity; 55% had multiple comorbidities. All cause- and COVID-19-related hospitalization rates at 28 days were 3.98% and 2.56%, respectively. After adjusting for medical comorbidities, there was no significant difference in all cause- and COVID-19-related hospitalization rates between bamlanivimab and casirivimab-imdevimab (adjusted HR, 1.4, 95% CI 0.9-2.2 and 1.6, 95% CI 0.8-2.7, respectively). Chronic kidney, respiratory and cardiovascular diseases, and immunocompromised status were associated with higher likelihood of hospitalization.

Conclusion: This observational study on the use of bamlanivimab and casirivimab-imdevimab in high-risk patients showed similarly low rates of hospitalization. The number and type of medical comorbidities are associated with hospitalizations after monoclonal antibody treatment.
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http://dx.doi.org/10.1093/infdis/jiab377DOI Listing
July 2021

Mild to moderate COVID-19 illness in adult outpatients: Characteristics, symptoms, and outcomes in the first 4 weeks of illness.

Medicine (Baltimore) 2021 Jun;100(24):e26371

Division of Infectious Diseases.

Abstract: Most patients with coronavirus disease 2019 (COVID-19) have mild to moderate illness not requiring hospitalization. However, no study has detailed the evolution of symptoms in the first month of illness.At our institution, we conducted remote (telephone and video) visits for all adult outpatients diagnosed with COVID-19 within 24 h of a positive nasopharyngeal polymerase chain test for SARS-CoV-2. We repeated regular video visits at 7, 14, and 28 days after the positive test, retrospectively reviewed the prospective data collected in the remote visits, and constructed a week by week profile of clinical illness, through week 4 of illness.We reviewed the courses of 458 symptomatic patients diagnosed between March 12, 2020, and June 22, 2020, and characterized their weekly courses. Common initial symptoms included fever, headache, cough, and chest pain, which frequently persisted through week 3 or longer. Upper respiratory or gastrointestinal symptoms were much shorter lived, present primarily in week 1. Anosmia/ageusia peaked in weeks 2 to 3. Emergency department visits were frequent, with 128 visits in the 423 patients who were not hospitalized and 48 visits among the 35 outpatients (7.6%) who were eventually hospitalized (2 subsequently died). By the fourth week, 28.9% said their illness had completely resolved. After the 4-week follow up, 20 (4.7%) of the 423 nonhospitalized patients had further medical evaluation and management for subacute or chronic COVID-19 symptoms.Mild to moderate outpatient COVID-19 is a prolonged illness, with evolving symptoms commonly lasting into the fourth week of illness.
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http://dx.doi.org/10.1097/MD.0000000000026371DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213280PMC
June 2021

A Framework for Outpatient Infusion of Antispike Monoclonal Antibodies to High-Risk Patients with Mild-to-Moderate Coronavirus Disease-19: The Mayo Clinic Model.

Mayo Clin Proc 2021 05 9;96(5):1250-1261. Epub 2021 Mar 9.

Division of Pediatric Infectious Diseases, Mayo Clinic, Rochester, MN.

The administration of spike monoclonal antibody treatment to patients with mild to moderate COVID-19 is very challenging. This article summarizes essential components and processes in establishing an effective spike monoclonal antibody infusion program. Rapid identification of a dedicated physical infrastructure was essential to circumvent the logistical challenges of caring for infectious patients while maintaining compliance with regulations and ensuring the safety of our personnel and other patients. Our partnerships and collaborations among multiple different specialties and disciplines enabled contributions from personnel with specific expertise in medicine, nursing, pharmacy, infection prevention and control, electronic health record (EHR) informatics, compliance, legal, medical ethics, engineering, administration, and other critical areas. Clear communication and a culture in which all roles are welcomed at the planning and operational tables are critical to the rapid development and refinement needed to adapt and thrive in providing this time-sensitive beneficial therapy. Our partnerships with leaders and providers outside our institutions, including those who care for underserved populations, have promoted equity in the access of monoclonal antibodies in our regions. Strong support from institutional leadership facilitated expedited action when needed, from a physical, personnel, and system infrastructure standpoint. Our ongoing real-time assessment and monitoring of our clinical program allowed us to improve and optimize our processes to ensure that the needs of our patients with COVID-19 in the outpatient setting are met.
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http://dx.doi.org/10.1016/j.mayocp.2021.03.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7942148PMC
May 2021

Double masking: Does science coincide with common sense?

Infect Control Hosp Epidemiol 2021 Apr 7:1-2. Epub 2021 Apr 7.

Department of Mechanical Engineering, University of Tulsa, Tulsa, Oklahoma.

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http://dx.doi.org/10.1017/ice.2021.155DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111192PMC
April 2021
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