“So far, since March 24, we have treated 350 patients (180 women and 170 men) with anti Sars-CoV-2 monoclonal neutralizing antibodies, 140 of which only from November 1st to today: in the last month and a half, in full fourth wave, especially unvaccinated people who, suffering from multiple pathologies, feared that the vaccine represented a danger to the already fragile balance. Thanks to these therapies, they were prevented from hospitalization, consequently we always have beds available, which is absolutely not taken for granted “. Like this Silvia Magnani, infectious disease specialist, responsible for the simple infectious disease structure of the Aos regional hospitalta, tells of his experience with monoclonal antibodies, a therapeutic treatment against Sars-Cov-2, in use since March 2021.
“In the beginning – recalls Magnani – the patients were almost all unvaccinated (at the time we were at the beginning of the immunization campaign against Covid), very fragile subjects, including transplanted, immunosuppressed and in any case with many comorbidities. Only for some of them, hospitalization was necessary, although they got help from monoclonals. None of these treated patients, however, went to death, despite being less protected at that time. Over time, the situation has changed, for the better. Since June, in fact , we did not need to prescribe oxygen at home, the clinical picture of the patients was less and less complicated also because the criteria for inclusion in the treatment have varied. Today the typical patient has undergone at least two doses of the anti Covid vaccine, often he hasn’t done the booster yet, and has an average age of 64 ”.
The fundamental thing, for the infectious disease specialist, is “intervene promptly“.” The organization of our hospital – Magnani again – makes use of teamwork that is possible with us because we are few in number: we have a single health company, a single emergency center, two special assistance continuity units (Usca ), therefore a centralization of resources also facilitated by numbers. However, ours is difficult territory because the valleys are far from the hospital. For this reason, the timeliness of reporting thanks to the execution of a third generation antigenic swab or a molecular swab is fundamental. In the decentralized valleys, however, people can swab in pharmacies which, however, is second generation and does not allow the Aifa prescription for treatment. At the hospital we receive the report from the doctors of the Usca but most of the time we need to confirm it with a molecular test, a practice that generally wastes 24 hours “.
“We have informed the population – underlines Magnani – therefore the patient with risk factors and a positive swab knows that he should immediately contact the treating physician or the Usca to report his positivity. All the data of the swabs carried out are recorded, so the Usca has the names of the new positives every day, studies the situation and every evening sends a report to our department with the candidates for treatment with monoclonals. We evaluate the application and send the 118 home to carry out the molecular swab or we study the possibility that the positive subjects move in the car and go to the drive-in. Once the results of the molecular swabs are obtained, we report them every evening to our Molecular Biology. For patients who we believe are candidates for therapy we ask that their swabs be processed with high priority. In a short time, in this way, we can define who will be able to undergo the treatment in the immediately following days “.
With concern, the expert looks at the Omicron variant: “In January we expect the peak of infections due to the South African variant. Omicron, although it seems to give only problems to the bronchi and not to the lungs, infects more than the other variants. The contagiousness is similar to that of the measles, a person with measles infects 13: we are talking about important numbers that will inevitably increase in this period of parties with greater movements, dinners and lunches. To face Omicron we are ready, we will use more sotrovimab, a new effective weapon that we have available against the new mutation of the virus. For now we have few doses of sotrovimab, so we will have to use it wisely “concludes Magnani.
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