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Change in Effectiveness of Sotrovimab for Preventing Hospitalization and Mortality for At-risk COVID-19 Outpatients During an Omicron BA.1 and BA.1.1-Predominant Phase

Aggarwal et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.10.002 (date from preprint)
Jun 2022  
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Mortality 38% Improvement Relative Risk Hospitalization 18% primary Progression -3% Sotrovimab  Aggarwal et al.  EARLY TREATMENT Is early treatment with sotrovimab beneficial for COVID-19? Retrospective 30,247 patients in the USA (December 2021 - March 2022) Lower hospitalization with sotrovimab (not stat. sig., p=0.32) Aggarwal et al., Int. J. Infectious Di.., Jun 2022 Favorssotrovimab Favorscontrol 0 0.5 1 1.5 2+
Sotrovimab for COVID-19
41st treatment shown to reduce risk in May 2023
*, now with p = 0.003 from 24 studies, recognized in 38 countries. Efficacy is variant dependent.
Lower risk for ICU admission and hospitalization.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments.
Retrospective 30,247 outpatients in the USA, showing no significant differences with sotrovimab with omicron BA.1.
Efficacy is variant dependent. In Vitro studies predict lower efficacy for BA.11-3, BA.4, BA.54, XBB.1.9.3, XBB.1.5.24, XBB.2.9, CH.1.15, and no efficacy for BA.26, ХВВ.1.9.1, XBB.1.16, BQ.1.1.45, and CL.15. US EUA has been revoked.
risk of death, 38.0% lower, RR 0.62, p = 0.62, treatment 1 of 1,542 (0.1%), control 7 of 3,663 (0.2%), odds ratio converted to relative risk.
risk of hospitalization, 17.5% lower, RR 0.82, p = 0.32, treatment 39 of 1,542 (2.5%), control 116 of 3,663 (3.2%), NNT 157, odds ratio converted to relative risk, primary outcome.
risk of progression, 2.8% higher, RR 1.03, p = 0.83, treatment 93 of 1,542 (6.0%), control 224 of 3,663 (6.1%), NNT 1189, odds ratio converted to relative risk, ED visit.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Aggarwal et al., 18 Jun 2022, retrospective, USA, peer-reviewed, 10 authors, study period 26 December, 2021 - 10 March, 2022. Contact:
This PaperSotrovimabAll
Change in effectiveness of sotrovimab for preventing hospitalization and mortality for at-risk COVID-19 outpatients during an Omicron BA.1 and BA.1.1-predominant phase
MD, MHSc Neil R Aggarwal, MS Laurel E Beaty, MD Tellen D Bennett, PhD, MS Nichole E Carlson, BS b ; David A Mayer, PharmD Kyle C Molina, RN Jennifer L Peers, MS c ; Seth Russell, MD, MPH Matthew K Wynia, MD, MPH Adit A Ginde
International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.10.002
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Conflict of interest The authors do not have a commercial or other association that might pose a conflict of interest (e.g., pharmaceutical stock ownership, consultancy, advisory board membership, relevant patents, or research funding)
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