Availability of Monoclonal Antibody for Treatment of COVID-19

The Eli Lilly monoclonal antibody for COVID-19 infection (bamlanivimab) is now available for Kettering Health Network patients who meet certain criteria. An infusion center has been created and will accept patients beginning Wednesday, November 25. An order set is available in EPIC which assists providers in determining eligibility. The drug is not indicated for the following groups of patients: 

a. Hospitalized patients 

b. Patients receiving supplemental oxygen 

c. Patients on home oxygen who are requiring increased amounts 

Patients with moderate illness will be prioritized over those with mild illness and this is reflected in the risk scores below. Patients must have a symptom duration and a positive COVID-19 test no more than 10 days prior to treatment. 

Mild illness: fever with mild respiratory symptoms including cough, sore throat, and malaise. 

Moderate illness: fever with cough, chills, shortness of breath, and findings of lower respiratory tract infection on imaging or examination, and an O2 saturation of > 94%. 

The following risk score can be calculated based on risk factors: 

1.Moderate illness*3 points 

2.Age > 65: 3 points 

3.BMI > 35: 3 Points 

4.Immunosuppressed*: 3 points 

5.Chronic kidney disease*: 2 points 

6.Diabetes mellitus*: 2 points 

7.Age > 55 with COPD*: 2 points 

8.Age > 55 with HTN or CAD/CHF: 1 point 

9.Mild illness: 1 point 

10.Symptoms for >10 days: multiply by 0 

*Immunosuppressed: patients on immunosuppressive medications or who have immunosuppressive disease (e.g. CLL) 

* CKD: stage 3 or above 

* Diabetes: with Hgb A1C >8 

*COPD: requiring home O2 (but at baseline flow rate) 

Patients whose score is >8 will be eligible for treatment. 

Referral instructions are included in the Epic order set. 

November 23, 2020