Name of the Procedure:

Intravenous Infusion of Casirivimab and Imdevimab
Medical Term: Intravenous infusion, casirivimab and imdevimab (HCPCS M0243)

Summary

This procedure involves administering a combination of two monoclonal antibodies, casirivimab and imdevimab, through an intravenous (IV) infusion. The treatment is designed to boost the immune response against certain viruses, such as SARS-CoV-2, and includes both the infusion process and monitoring afterwards to ensure patient safety.

Purpose

Medical Conditions: Primarily used for the treatment of COVID-19 in patients who are not hospitalized but are at high risk for developing severe symptoms.
Goals: To reduce the severity of the illness, prevent hospitalization, and speed up the recovery process.

Indications

Symptoms or Conditions:

• Mild to moderate COVID-19 symptoms.
• High risk factors such as age, underlying health conditions, or immunocompromised status.

Patient Criteria:

• Positive COVID-19 test.
• Not requiring hospitalization or supplemental oxygen.
• High risk for progressing to severe COVID-19.

Preparation

• Fasting: No special fasting required.
• Medication Adjustments: Inform your healthcare provider about all medications you are taking.
• Pre-Assessment: Vital signs and medical history are reviewed. Possible allergy tests may be conducted.

Procedure Description

1. Patient Arrival: Patient arrives at the healthcare setting.
2. IV Line Placement: A nurse or healthcare professional places an IV line in the patient's arm.
3. Infusion: The monoclonal antibodies, casirivimab and imdevimab, are administered through the IV over approximately 20-50 minutes.
4. Monitoring: Post-infusion monitoring for at least one hour to check for adverse reactions or side effects.

Tools and Equipment: IV catheter, infusion pump, monitoring devices.

Anesthesia or Sedation: Not required for this procedure.

Duration

The entire process, including pre-infusion setup and post-infusion monitoring, typically takes about 2-3 hours.

Setting

The procedure can be done in a hospital, outpatient clinic, or specialized infusion center.

Personnel

• Nurses: Administer the infusion and monitor the patient.
• Physicians: Oversee the entire procedure and handle any complications that may arise.
• Pharmacists: Prepare the infusion solution.

Risks and Complications

Common Risks: Mild allergic reactions, nausea, dizziness.
Rare Risks: Severe allergic reactions (anaphylaxis), infusion-related reactions, worsening of COVID-19 symptoms.

Management: Immediate treatments are available on-site to manage severe reactions.

Benefits

Expected Benefits:

• Reduction in symptoms severity.
• Decreased risk of hospitalization.
• Faster recovery from the infection.
  Timeframe: Benefits typically realized within a few days to a week.

Recovery

Post-Procedure Care:

• Monitor for delayed side effects.
• Continue following public health guidelines (mask, social distancing, etc.)
  Recovery Time: Immediate return to normal activities, with caution for 24-48 hours.
  Follow-Up: As advised by the healthcare provider, usually within a week.

Alternatives

Other Treatment Options:

• Antiviral medications such as Remdesivir.
• Supportive care including rest, fluids, and over-the-counter medications.
• Hospital-based therapies for severe cases.

Pros and Cons of Alternatives:

• Monoclonal antibodies specifically target the virus and can be more effective for high-risk patients.
• Antivirals and supportive care may be less targeted but still beneficial, especially for lower-risk patients.

Patient Experience

During Procedure:

• Mild discomfort from the IV placement.
• Possible sensations of cold as the infusion begins.

After Procedure:

• Possible mild fatigue or headache.
• Pain management not typically required, but over-the-counter pain relief can be used if necessary.

Comfort measures include being in a comfortable chair, having access to water and snacks, and reading or watching TV during the infusion process.