Effect on SARS-CoV-2 viral load using combination therapy with casirivimab/imdevimab and remdesivir

Evidence suggests that SARS-CoV-2 viral load is an independent predictor of disease severity and mortality. A 61-year-old woman presented with severe COVID-19 and was treated with casirivimab/imdevimab and remdesivir. Quantitative nasopharyngeal (NP) viral loads were trended throughout the treatment course. Baseline NP viral load was 25,860,901 copies/mL (7.4 log10). Casirivimab/imdevimab was administered, with subsequent reduction in NP viral load to 26,049 copies/mL (4.4 log10) on hospital day 4. A repeat NP viral load on day 7 was 13,113 copies/mL (4.1 log10). Despite uncertainty regarding correlation with reduction in viral load and outcomes, NP viral load may be considered when selecting treatment options and evaluating treatment response in hospitalized patients with early infection.