單株抗體治療新冠肺炎經驗

Experience of Using Monoclonal Antibodies for COVID-19

自從2021年5月中旬，北台灣爆發新冠肺炎（COVID-19）以來，快速增加的嚴重，或是重症病患衝擊了醫療照護體系，以及重症加護的能量。老年人和具有慢性共病疾患，例如高血壓、糖尿病、或是慢性腎病等，都是發展為重症或是死亡的高危險群。除了使用類固醇或是瑞德西韋治療嚴重的COVID-19病人，也有越來越多的證據支持，使用中和性單株抗體，能夠減少輕度或是中度COVID-19患者的住院或是死亡率。為了在台灣這一波社區流行中，減少COVID-19輕度和中度患者的病情惡化或是死亡，自2021年6月中旬起，引進單株抗體治療輕症，但是高風險的患者。至2021年7月底為止，我們使用了casirivimab／imdevimab以及bamlanivimab／etesevimab治療了26位，至少具有一項風險因子的患者。沒有任何一位接受單株抗體治療的患者，有出現病情惡化或是死亡。

As a surge of COVID-19 cases in northern Taiwan since mid-May 2021, rapidly escalated severe or critical ill patients impacted our health care system and intensive care reserve capacity. Elderly people and those who had comorbidities such as hypertension, diabetes or chronic kidney disease were at high risk for development of critical disease or death. Except for using steroids and remdesivir as treatment options for COVID-19 patients with severe disease, more and more evidence supported the use of neutralizing monoclonal antibodies to decrease hospitalization rate and mortality of COVID-19 for patients with mild to moderate disease. To avoid disease progression among COVID-19 patients who have mild to moderate disease, monoclonal antibodies for COVID-19 had been used to at risk patients since mid-June 2021. Before the end of July 2021, we used casirivimab/imdevimab and bamlanivimab/etesevimab for 26 COVID-19 patients who had at least one risk factor of disease progression in Far Eastern Memorial Hospital. No disease progression or death had been observed after treatment with monoclonal antibodies.