“Anti-Covid monoclonals in home therapy? Mine is a ‘no’. Not because it would not be possible but because there are two important problems: patient selection, which is quite complex. And the management of any adverse effects”. Antonella D’Arminio Monforte, director of Infectious Diseases, Asst Santi Paolo e Carlo of Milan – one of the departments that administers, with the authorization of the AIFA, the treatment – explained this to Adnkronos Salute – intervening on the possibility of using monoclonal antibodies on the territory, in coordination with the hospital, as the new ministerial protocol for anti-Covid home care could provide, which is expected in days.
For the selection of patients, in particular, “a ‘trained eye’ is needed – specifies the infectious disease specialist – because the therapy can only be done to patients who do not have a too advanced infection, who have risk factors for development of a more serious infection and who have had symptoms for less than 10 days. Unfortunately, the patients who are referred to us by general practitioners and who are suitable for them, are not suitable for us. The great risk is patient selection ” .
In addition to the problem of choice, however, there is also the problem of any risks of anaphylactic shock, which can be managed less easily on the territory. These drugs are administered, in fact, “in a vein, in about an hour, it is not the same thing as an oral or an intramuscular drug. The doctor must plan to stay two hours with the patient, for any eventuality. It is also necessary to provide for “assistance with the possibility of resuscitation emergencies, albeit rare. Up to now we have administered over 30 therapies in our center and we have had only one case, mild, of shock”.