Antibody Resource Guide

COVID-19 Antibody Treatment Resource Guide

The National Infusion Center Association has developed the resources described below to support  prescribers, infusion providers, and patients in the safe and efficient use of COVID-19 antibody treatments.  These resources can be found in the COVID-19 Antibody Treatment Resource Center.

Locating Sites of Care

NICA COVID-19 Locator 

Use NICA’s COVID-19 Locator Tool to identify sites of care administering COVID-19 antibody therapies.

Prescribers & Patients: 

  • Simply enter your city and state or your zip code and click “search” 
  • Click on a location to view site details including phone number, hours of operation, website,  amenities, and more.  
  • If results do not populate for the area searched, try widening the search radius. If there are still no  results to display, contact your local/regional health authorities as your state may not have opted  into our locator program yet. 

Infusion Providers: 

  • Be sure patients can find your infusion site by “claiming” your location and adding pertinent details  to the profile like phone number, hours of operation, amenities, and more.  
  • Consider using the URL field to direct prescribers and patients to pertinent information on your  center’s website, such as patient arrival instructions, required forms, etc.  
  • If you need assistance claiming your center or building out your profile, email covid19@infusioncenter.org.

This national map is maintained by the Department of Health and Human Services and displays locations  that have received shipments of COVID-19 antibody therapies.  

  • If results do not populate for the area searched, try widening the search radius. If there are still no  results to display, contact your local/regional health authorities as your state may not have opted  to have their locations displayed. 
  • It is important to note that locations are displayed based on the address where medication was  shipped (e.g., centralized pharmacy, warehouse) and may not reflect the location/address where  patient care is provided. 

COVID-19 Antibody Treatment Indication Checklist

This checklist is intended to help prescribers determine if treatment with COVID-19 antibodies is  authorized for use in accordance with the Emergency Use Authorization (EUA) requirements.  • If COVID-19 antibody treatment is not indicated, the checklist can be included in the medical  record to document the clinical decision-making process.  

  • If COVID-19 antibody treatment is indicated, the checklist can accompany the medication order to  document eligibility criteria and support medical necessity. Individual infusion site documentation requirements may vary

COVID-19 Antibody Treatment Order Set

An order set is developed for each approved COVID-19 antibody therapy and serves as the prescription  for treatment. 

  • Facilitates proper prescribing by capturing the necessary elements of a valid, complete COVID-19  antibody treatment infusion order 
  • Captures criteria for authorized use mandatory reporting requirements per EUA.  • Guides infusion clinician in safe administration by prompting best practices and adherence to  administration requirements.
  • Supports continuity of care by prompting the infusion provider to send records of completed  treatment to the prescriber. 

Coding Guide

List of common diagnosis codes that may apply to eligible patients.‡ 

  • Provides prescriber with easy access to codes needed to complete order set and indications  checklist 
  • ICD-10 data helps public health officials understand which patient populations are receiving  COVID-19 therapeutics to support efforts aimed at equitable allocation and distribution of  COVID-19 therapeutics. 

Referral Checklist

Many HCPs prescribing COVID-19 antibody treatments may be unfamiliar with the infusion referral  process. As COVID-19 antibody treatments are thought to be most effective when given as early as  possible in the disease course, it is critical to streamline the referral process to reduce unnecessary delays  to expedite access to treatment and optimize outcomes. This checklist provides a template overview of  necessary steps to refer a patient for COVID-19 antibody treatment. 

  • Infusion sites of care are encouraged to download and modify this checklist to create a custom  checklist including any unique, site-specific requirements. 

Patient Education: Preparing for a COVID-19 Antibody Infusion

Prescribers can provide and review this handout with patients to help them understand and prepare for  their infusion to promote treatment acceptance and adherence.  

  • Includes a field for prescriber to indicate facility name and phone number where referral/order  was sent, with instruction for patient to call if they have not received an appointment promptly.  This is intended to reduce treatment delays or patients “timing out” of treatment eligibility due to  communication challenges. 

Casirivimab + Imdevimab Flowsheet / Bamlanivimab Flowsheet

The flowsheet, sometimes called a treatment note, is used to document all care associated with  administration of COVID-19 antibody therapies.  

  • Guides the clinician to follow industry standards and best practices as well as adhere to  administration and documentation requirements under the EUA. This is not an all-inclusive list of diagnoses meeting EUA criteria for high risk for progressing to severe  COVID-19 and/or hospitalization.
  • Provides a detailed record to fax to the referring prescriber for inclusion in the patient’s medical  record.
  • Especially helpful for temporary sites of care or other infusion providers using paper  documentation. 

Drip Rate Tables

In sites of care administering infusions by gravity (as opposed to with an infusion pump or other rate control device), HCPs will be required to calculate the appropriate drip rate using the volume to be infused  and drop factor of the administration set used (infusion tubing). As many HCPs may be unfamiliar with the  calculations required, these tables provide the appropriate drip rates for administration of both products  using administration sets with any drop factor.

Casirivimab + Imdevimab Medication Safety Alert

Casirivimab and Imdevimab are supplied in multiple packaging configurations and have unique preparation  requirements that may increase risk for medication errors. 

  • Provides considerations and strategies to reinforce use of proper quantities/combinations of  product to prepare a single dose. 

Patient Education: COVID-19 Antibody Treatment Discharge Instructions

This patient handout explains signs and symptoms to watch for and report following a COVID-19 antibody  infusion.  

  • Provides home care instructions for discomfort at the IV site 
  • Reinforces the need to continue isolation to prevent disease transmission
  • Lists emergency warning signs that necessitate seeking medical attention

NICA Standards for In-Office Infusion

View NICA’s minimum standards for the administration of intravenous and injectable medication in an  outpatient setting. 

Eli Lilly Bamlanivimab Playbook

NICA collaborated with Eli Lilly to develop this playbook with in-depth information about preparation and  administration of bamlanivimab as well as other considerations for operationalizing an infusion site. 

Regeneron Casirivimab + Imdevimab Emergency Use Authorization (EUA) Guidebook

NICA collaborated with Regeneron to develop this playbook with in-depth information about preparation  and administration of casirivimab + imdevimab as well as other considerations for operationalizing an  infusion site. 

Report an Adverse Event to MedWatch

Healthcare providers must submit a report on all medication errors and all serious adverse events  potentially related to COVID-19 antibody therapy. 

Multilingual COVID-19 Resources

The CDC has developed the COVID-19 Communication Toolkit: For Migrants, Refugees, and Other  Limited-English-Proficient Populations in various languages. Resources are available in Spanish, Simplified  Chinese, Korean, Tagalog, Hmoob (Hmong), Af Soomaali (Somali), and Vietnamese.

Copyright © 2020 | COVID Frontline | All Rights Reserved | Website by Divigner

Patient Toolkit

The COVID FRONTLINE Patient Toolkit is a resource center for patients who have been diagnosed with or who are interested in learning about COVID-19. Choose from the options below to learn more.

Clinical Toolkit

The COVID-19 Clinical Toolkit is an online tool that aims to provide clinicians with up-to-date information on the presentation, prognosis, pathophysiology, and treatment strategies for COVID-19. Click on one of the options below to learn more.

This activity is provided by Med Learning Group. This activity is co-provided by Ultimate Medical Academy/CCM.
This activity is supported by educational grants from AbbVie, Astellas, Genentech, Merck & Co., Inc., and Pfizer.

Copyright © 2019 | COVID Frontline | All Rights Reserved | Website by Divigner

Updates in the Treatment and Prevention of COVID-19​

Emergency use authorization for casirivimab/imdevimab in patients with mild-to-moderate COVID-19

The combination of the monoclonal antibodies casirivimab and imdevimab (previously known as REGN-COV2) has been authorized for emergency use for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients (≥12 years of age and ≥40 kg) who are at high risk for progressing to severe COVID-19 or hospitalization.1

Interim results from 275 nonhospitalized patients in a placebo-controlled trial of casirivimab plus imdevimab found that the combination therapy reduced viral load, with a greater effect in patients whose immune response had not yet been initiated or who had a high viral load at baseline. Patients who received casirivimab/imdevimab required fewer medical visits for COVID-19 than patients who received placebo (3% vs 6%, respectively). Among patients who were serum antibody-negative at baseline, 15% in the placebo group and 6% in the treatment group required COVID-19-related medical care.2 

Baricitinib in combination with remdesivir authorized for emergency use in hospitalized patients

Baricitinib, in combination with remdesivir, is authorized for emergency use in adult and pediatric patients ≥2 years of age hospitalized for COVID-19 who require supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).3

A recent trial of 1033 patients hospitalized for COVID-19 found that baricitinib plus remdesivir was superior to remdesivir alone in reducing recovery time (7 days vs 8 days, respectively; P= .03). Patients receiving high-flow oxygen or noninvasive ventilation at enrollment had a time to recovery of 10 days with combination therapy and 18 days with the control (rate ratio for recovery, 1.51). The addition of baricitinib to remdesivir was associated with 30% higher odds of improvement in clinical status at day 15 compared with remdesivir alone.4 

 

References 

  1. Emergency use authorization (EUA) of casirivimab and imdevimab. Available at fda.gov/media/143892/download Accessed 12/23/2020.
  2. Weinreich DM, Sivapalasingam S, Norton T, et al. REGN-COV2, a neutralizing antibody cocktail, in outpatients with Covid-19. N Engl J Med. 2020;Dec 17:Epub ahead of print. Available at nejm.org/doi/full/10.1056/NEJMoa2035002Accessed 12/23/2020.
  3. Emergency use authorization (EUA) of baricitinib. Available at fda.gov/media/143823/download Accessed 12/23/2020.
  4. Kalil AC, Patterson TF, Mehta AK, et al. Baricitinib plus remdesivir for hospitalized adults with Covid-19. N Engl J Med. 2020;Dec 11:Epub ahead of print. Available at nejm.org/doi/full/10.1056/NEJMoa2031994 Accessed 12/23/2020.