Efficacy of Remdesivir and Neutralizing Monoclonal Antibodies in Monotherapy or Combination Therapy in Reducing the Risk of Disease Progression in Elderly or Immunocompromised Hosts Hospitalized for COVID-19: A Single Center Retrospective Study

Abstract: viruses Article Efficacy of Remdesivir and Neutralizing Monoclonal Antibodies in Monotherapy or Combination Therapy in Reducing the Risk of Disease Progression in Elderly or Immunocompromised Hosts Hospitalized for COVID-19: A Single Center Retrospective Study Davide Fiore Bavaro 1, * , Lucia Diella 1 , Alessandra Belati 1 , Giuliana Metrangolo 1 , Laura De Santis 1 , Vito Spada 1 , Michele Camporeale 1 , Angelo Dargenio 1 , Gaetano Brindicci 1 , Flavia Balena 1 , Deborah Fiordelisi 1 , Fabio Signorile 1 , Giacomo Loseto 2 , Crescenza Pasciolla 2 , Carla Minoia 2 , Immacolata Attolico 3 , Tommasina Perrone 3 , Simona Simone 4 , Maria Rendina 5 , Nicoletta Giovine 6 , Francesco Di Gennaro 1 , Pellegrino Musto 3,7 , Attilio Guarini 2 , Alfredo Di Leo 5 , Loreto Gesualdo 4 , Maria Dell’Aera 6 and Annalisa Saracino 1 1 2 3 4 Citation: Bavaro, D.F.; Diella, L.; 5 Belati, A.; Metrangolo, G.; De Santis, L.; Spada, V.; Camporeale, M.; 6 Dargenio, A.; Brindicci, G.; Balena, F.; 7 et al. Efficacy of Remdesivir and Neutralizing Monoclonal Antibodies * Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy Unit of Hematology and Stem Cell Transplantation, AOUC Policlinic, 70124 Bari, Italy Nephrology Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy Hospital Pharmacy Department, University Hospital of Bari, 70124 Bari, Italy Department of Precision and Regenerative Medicine and Ionian Area University of Bari and Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, 70124 Bari, Italy Correspondence: davidebavaro@gmail.com; Tel.: +39-080-5594529; Fax: +39-080-5592301 in Monotherapy or Combination Therapy in Reducing the Risk of Disease Progression in Elderly or Immunocompromised Hosts Hospitalized for COVID-19: A Single Center Retrospective Study. Viruses 2023, 15, 1199. https://doi.org/ 10.3390/v15051199 Academic Editors: Karolina Akinosoglou, George T. Dimopoulos and Wei Xu Received: 29 April 2023 Revised: 16 May 2023 Accepted: 17 May 2023 Published: 19 May 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article Abstract: Introduction: Remdesivir (REM) and monoclonal antibodies (mAbs) could alleviate severe COVID-19 in at-risk outpatients. However, data on their use in hospitalized patients, particularly in elderly or immunocompromised hosts, are lacking. Methods: All consecutive patients hospitalized with COVID-19 at our unit from 1 July 2021 to 15 March 2022 were retrospectively enrolled. The primary outcome was the progression to severe COVID-19 (P/F < 200). Descriptive statistics, a Cox univariate–multivariate model, and an inverse probability treatment-weighted (IPTW) analysis were performed. Results: Overall, 331 subjects were included; their median (q1–q3) age was 71 (51–80) years, and they were males in 52% of the cases. Of them, 78 (23%) developed severe COVID-19. All-cause in-hospital mortality was 14%; it was higher in those with disease progression (36% vs. 7%, p < 0.001). REM and mAbs resulted in a 7% (95%CI = 3–11%) and 14% (95%CI = 3–25%) reduction in the risk of severe..