North Texas Obgyns Need to Know About Monoclonal Antibodies for Covid-19

Dr. Jeff Livingston

Understanding the North Central Texas COVID- 19 Regional Infusion Center process

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The Covid-19 Delta variant continues to attack North Texas. It is time for community Obgyn physicians and providers to help the growing number of infected patients get access to effective and early treatment. 

Monoclonal antibody therapy reduces the risk of hospitalization and severe disease. Pregnant people qualify for treatment, but they need to get the treatment as early as possible.

Our company, MacArthur Medical Center’s core values include INNOVATION and EXCELLENCE. We stay at the cutting edge to promote the best care possible to our patients.

Our company has started offering monoclonal antibody treatments to any pregnant patient who tests positive for Covid-19. We also refer gynecologic patients who meet the criteria. 

We share this protocol to help other practices learn of this treatment’s value and to provide a roadmap to integrate a similar option inside of their own practice

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Here is what all Obgyn practices need to know.

Regneron is a medication approved by the FDA under emergency use authorization for the treatment of Covid-19 for those early in the infection and at high risk of developing severe disease.

All pregnant people diagnosed with Covid-19 are considered high risk. Pregnancy naturally suppresses the immune system which predisposes pregnant people for worse outcomes when they are infected with a viral illness. 

Regeneron is a combination of two medications, Casirivimab and Imdevimab. Regeneronmakes use of monoclonal antibodies to fight the disease. These antibodies are similar to the ones our body would naturally produce in response to infection.

Monoclonal antibodies are mass-produced in a laboratory and are designed to recognize a specific component of the Covid-19 virus — the spike protein on its outer shell. These specific antibodies interfere with the virus’s ability to attach and gain entry into human cells by targeting the spike protein. 

Monoclonal antibodies give the immune system a leg up until it can mount its response.

Most pregnant people who contract Covid-19 do well. But the studies are clear that Covid-19 increases the risk of preterm labor, ICU admission, intubation, and death.

For a practice to successfully integrate monoclonal antibody therapy into practice, we must focus on teamwork. Everyone in the practice should have some basic knowledge of this treatment option to make certain cases are identified and referred early in the infection when the treatment is most effective. 

We must work together to give our patients to best chance possible to stay healthy after being diagnosed with Covid-19. 

Remember: Getting vaccinated against Covid is the best approach. All medical providers and teammates should encourage every patient to protect themself and others. Protect our moms, babies, and children. 

Who qualifies for monoclonal antibody therapy? 

Patients must meet at least ONE of the following criteria:

  • Pregnancy
  • High-risk Ethnicity Groups (Latin X or Black)
  • Older age (for example, age ≥ 65)
  • Obesity or being overweight (for example, BMI > 25 kg/m2)
  • Chronic kidney disease, diabetes, or
  • Immunosuppressive disease
  • Currently receiving immunosuppressive treatment
  • Heart disease 
  • High Blood pressure 
  • Chronic lung diseases
  • Sickle cell disease
  • Neurodevelopmental disorders

Additionally, patients must meet ALL the following criteria:

  • 12 years of age or older
  • The patient is symptomatic (not asymptomatic) and has mild to moderate illness.
  • Day 10 or less since symptom onset or testing positive.
  • Documented positive COVID test performed
  • Not requiring Oxygen therapy 

Where is monoclonal antibody therapy done?

The State of Texas has placed The Regional Infusion Center 8th Avenue in Fort Worth near Cooks Children’s Medical Center. A physician must refer patients. Patients cannot refer themselves, and all treatments must be scheduled in advance.

Monoclonal antibody treatment is free. It is funded by the state of Texas. There is no cost to the patient.

The RIC (Regional infusion Center operates seven days a week from 8:00 AM — 6:00 PM. 

How can a practice refer a patient for monoclonal Antibody Therapy? 

  1. Confirm the patient has a positive Covid test. 
  2. Confirm the patient meets the eligibility criteria listed above. 
  3. Fill out the Statewide RIC Infusion Referral Form. We recommend placing a copy of this required form inside of the practice's electronic health record to help medical assistants and referral coordinators have easy access. 
  4. Fax the RIC Infusion Referral Form to 210–208–5295 or send it by email to InfusionReferral@bcfs.net
  5. An Infusion Center Representative will reach out to the patient to schedule an appointment

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Dr. Jeff Livingston is nationally recognized thought leader, speaker, writer, blogger and practicing physician who is considered an expert in the use of social media to educate patients, using new and innovative technology to improve care outcomes and the patient experience. He is a prating Obgyn and serves as the CEO of MacArthur Medical Center. Dr. Jeff is the co-founder of the health website Medika.life and an active blogger on Medium.

Irving, TX
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