Brooke Army Medical Center opened a new infusion clinic to help high risk COVID-19 patients with moderate to mild symptoms at Joint Base San Antonio-Fort Sam Houston, Texas.
The treatment involves IV infusion of investigational antibody medications that are not Food and Drug Administration approved but are authorized under an FDA emergency use authorization.
"The goal of this treatment is to halt the progression of COVID and to hopefully prevent inpatient admission," said Air Force Maj. (Dr.) Joseph Yabes Jr., Infectious Disease Clinic officer in charge. "Overall, people have had good responses to this therapy."
The infusion therapy can be given to patients 12 years and older who weigh at least 88 lbs. However, patients who are more than 65 years old and those with a body mass index over 35 have benefited the most from the treatment.
"People who are immunocompromised, diabetic, or people who are age 55 with hypertension or COPD [chronic obstructive pulmonary disease] may also benefit from this therapy," Yabes explained.
A primary care manager must refer the patient to the COVID-19 Infusion Clinic. If the patient meets the criteria, someone from the infusion clinic will contact them to schedule the appointment. Once the patient arrives at BAMC, they have a designated parking space and are instructed to call the clinic.
"We don't want to bring someone who is acutely sick with COVID and infectious to sit next to someone who is immunocompromised," Yabes said. "The clinic was opened to provide a safe and monitored environment to facilitate antibody infusion and to prevent potential exposures to others."
After the patient calls the clinic, a technician goes to meet the patient and escorts them from the entrance to the clinic to ensure they don't get lost. Once in the clinic, a nurse takes their vital signs to ensure they don't need to be admitted to the hospital for treatment.
"The goal of this is to prevent hospital admission," Yabes said. "If you are at the point where you need to be admitted to the hospital, the best course of action is to be admitted and receive alternative therapies not a monoclonal antibody."
Once the patient reviews the disclosure documents and agrees to the treatment, the pharmacy begins to prepare the medications. The technician retrieves the medication from the pharmacy and starts the infusion process. The patient is continually monitored during the infusion process, which takes about an hour. After the infusion is complete, the patient is monitored for another hour before leaving the clinic.
"During the treatment, the patient can watch TV, read, listen to music or just relax," Yabes said. "We do ask that they keep their masks on at all times and not eat or drink while they are here."
Currently, the COVID-19 Infusion Clinic can support up to four patients per day. Prior to the clinic opening, patients were able to receive the antibody infusion therapy in the emergency department.
Retired Army Command Sgt. Maj. Paul Cardona, 69, and his wife, retired Army Sgt. 1st Class Marie Cardona, 66, tested positive for COVID-19 and fit the criteria for the monoclonal antibody therapy.
"I was provided literature about the treatment, and the clinic called me to see if I would be interested in receiving the treatment," Paul Cardona said. "Before I received the treatment, I was feeling pretty bad."
He had a sore throat, headache, chills and body aches.
"I was hurting all over," he said. "As soon as I received the antibody treatment, within days, my symptoms started to calm down and went away. I started feeling 100 times better."
Marie Cardona's COVID-19 symptoms included extreme fatigue, body aches, cramps and an intense headache.
"I would walk into the living room and pass out on the couch," she said. "The body aches and cramping would wake me up in the middle of the night. I wasn't able to sleep because I was in so much pain."
"I had seen the reaction Paul had to the treatment, so I went in and did it," she said. "The first night after the treatment I didn't see a difference, but the next day the cramps, body aches and the headache were better."
People who have already received their COVID-19 vaccination are not eligible for this treatment, and patients who receive the infusion therapy should wait at least 90 days before getting the COVID-19 vaccine.
So far, BAMC has provided the antibody therapy treatment to 59 patients. Of those, only five required hospital admission.
The Cardona's were thankful they were able to receive the monoclonal antibody infusion therapy.
"They have a bunch of professionals in that clinic," Paul Cardona said. "The nurses constantly monitored me throughout the treatment and told me exactly what was happening."