Short-Term Pregnancy Outcomes Following Monoclonal Antibody Treatment for COVID-19 Infection during the Omicron Surge

Background: Monoclonal antibody (mAb) therapy has been recommended in non-hospitalized COVID-19 positive pregnant individuals with mild to moderate symptoms despite data on safety and efficacy. Objective: To assess short-term outcomes of mAb treatment in COVID-19 positive pregnant patients during the Omicron surge. Methods: This is a descriptive study of pregnant patients receiving mAb therapy from December 1, 2021, and March 18, 2022 during the Omicron surge. Patients received either (1) sotrovimab, or (2) bamlanivimab/etesivimab, or (3) casirivimab/ imdevimab. We reviewed the medical records of pregnant patients who received mAb, gathering baseline demographics and assessing adverse events from mAb infusion. Results: Twenty-one pregnant patients received mAbs during the Omicron surge. The short-term maternal outcomes for most of our cohort were favorable. One patient developed an anaphylactic reaction following infusion of bamlanivimab/etesevimab. One patient required admission to the intermediate care unit for severe COVID-19 fifteen days following infusion, and a second patient developed cardiorespiratory symptoms concerning for post-acute sequelae SARS-CoV-2 infection. Adverse pregnancy outcomes were present in 43.7% of our delivered cohort (n=16). Conclusion: Short-term outcomes in pregnant patients who received monoclonal antibodies for COVID-19 during the Omicron surge are mostly favorable, with symptom resolution and rare adverse events