COVID-19 Hospital Neutralizing Antibodies (Casirivimab-Imdevimab) Orders

NOTE: supply of these medications can vary week to week and facility to facility. It is important to follow local updates about medication availability and the latest recommendations for preferred medications.

Casirivimab-Imdevimab ("REGEN-COV", single 4000/4000 mg dose) may be used to treat hospitalized patients aged 12 years or older weighing at least 40 kg with acute laboratory-confirmed COVID-19, if specific conditions are met.

Clinical Requirements

  • COVID-19 naive (no prior COVID-19 disease), meeting all of the following criteria:

    1. No documented history of prior COVID-19 infection

    2. No prior treatment with a COVID-19 neutralizing antibody (except bamlanivimab monotherapy)

    3. No prior COVID-19 vaccination unless within 14 days of a first dose

    4. Seronegative, based on results from a laboratory-based or rapid serology test

  • Immunocompromised, as defined by any of the following:

    1. Congenital and acquired immunodeficiency, including severe combined immunodeficiency (SCID) and profound hypogammaglobulinemia

    2. HIV infection with CD4 T lymphocyte count <200 (or less than 15%) and unsuppressed viral load

      • Pediatrics: 5 years or older – use CD4 count <200

    3. Any haemotological malignancy

    4. Within 24 months of stem cell transplant

    5. Solid organ transplant

    6. Current receipt of prednisone >20 mg/day (or equivalent) for more than 14 days

      • Pediatrics: >2 mg/kg body weight for more than 14 days

    7. Chimeric antigen receptor (CAR) T-cell therapy

      • Anti-B cell therapy (current or within last 6 months), e.g., ocrelizumab, rituximab

Research Requirements

  • Inpatients admitted for non-COVID reasons with nosocomial COVID-19 infection and enrolled in the CATCO-NOS clinical trial (1200/1200 mg dose).