David Farley
When David Farley tested positive for COVID-19, he was determined to do everything he could to avoid developing serious complications.
“I have diabetes and hypertension, so I knew I was at risk for getting really sick,” he said. “I didn’t want to end up in the hospital, like the people you see on the news.”
Farley, 57, called his family doctor, Brian J. Young, MD, of Penn Medicine Lancaster General Health Physicians Family Medicine Twin Rose. Because of Farley’s medical conditions, Young recommended monoclonal antibody infusion, a highly effective treatment for patients who are at risk for developing severe illness from COVID-19.
Monoclonal antibody infusion is shown to significantly reduce the risk of hospitalization or death in people age 65 or older, and those with certain chronic medical conditions, such as diabetes, heart disease, or obesity. Children ages 12 and over who have serious medical conditions may also benefit from the treatment.
“Nationally, individuals with certain risk factors who develop COVID-19 have a 15 percent chance of being hospitalized,” said Young, who also serves as medical director of Care Transformation at Lancaster General Health (LG Health). “The infusion treatment reduces that risk to less than 5 percent.”
Monoclonal antibodies are laboratory-made proteins that effectively boost the immune system’s ability to fight the COVID-19 virus, he explained. Patients receive an intravenous (IV) infusion of a medication containing the antibodies, which is most effective when given early in the course of illness. The treatment process takes about two and a half hours, which includes an hour-long observation period after the infusion.
Monoclonal antibody infusion received an emergency use authorization from the U.S. Food and Drug Administration in late 2020, following successful clinical trials at Penn Medicine and other institutions. Despite endorsements from such high-profile recipients as former President Donald Trump, the treatment was slow to catch on at first for a number of reasons, including logistical factors, as well as some patients’ reluctance to receive it.
Keith W. Hamilton, MD, an Infectious Diseases specialist, an associate professor of Clinical Medicine, and Chair of the Penn Medicine COVID-19 Therapeutics Committee, said
monoclonal antibody infusion has been offered at locations throughout the health system since late 2020. In Philadelphia, 375 patients to date have received an infusion at the Perelman Center for Advanced Medicine.
More than 500 patients have received the infusion treatment at an LG Health Urgent Care location, where it is administered in a dedicated area to protect other patients and staff from exposure to COVID-19. In addition, LG Health also provided the treatment to nearly 200 Lancaster County residents at retirement communities and personal care homes.
“Most patients feel remarkably better, usually within 24 hours after the infusion,” Young said. “At LG Health, our results are similar to what has been seen nationally, with a hospitalization rate of just under 5 percent for patients who have received the treatment, compared to the national hospitalization rate of up to 15 percent for COVID-19 patients who did not receive the treatment.”
The infusion treatment comes with minimal side effects, including a 1 percent risk of a severe allergic reaction (anaphalaxis), he said. The observation period serves to identify those reactions, as well as other minor temporary side effects, such as nausea or low blood pressure. In addition, because the treatment could impact the effectiveness of the COVID-19 vaccine, patients are advised to wait three months before getting vaccinated.
The infusion treatment is provided for free or at minimal cost for most patients. LG Health assists in resolving transportation or other concerns that may affect patients’ ability to access the treatment. Elsewhere in the Penn Medicine system, in-home infusions are available to help overcome these barriers, which may be complicated by socioeconomic factors.
While the treatment is beneficial, some patients can be hesitant to move forward with it. At LG Health, less than half of patients who are offered the treatment initially accept it, Young said. He attributes some of that reluctance to concerns about the treatment’s emergency use authorization, adding that many patients’ worries diminish after speaking with their physician.
David Farley had no such hesitation about receiving the treatment. Despite faithfully following COVID-19 precautions, he was exposed in March, after spending time with a family member who later tested positive. After his own positive test, he developed only minor symptoms, including congestion and a cough.
Farley was determined to prevent his illness from worsening and to safely return to his work at the local QVC warehouse and his longtime role as a high-school track coach. He had spent time in the hospital earlier in his life, and he didn’t want to return.
Farley had the infusion treatment early in his illness, with a successful outcome. His symptoms quickly improved, and he returned to work and his normal activities a week later. The treatment also gave him peace of mind.
“I immediately felt better after the infusion,” he said. “I think it was the best thing ever.”