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

DOI record: { "DOI": "10.3390/v15051199", "ISSN": [ "1999-4915" ], "URL": "http://dx.doi.org/10.3390/v15051199", "abstract": "<jats:p>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 &lt; 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 &lt; 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 COVID-19, respectively, after adjusting the analysis with the IPTW. In addition, by evaluating only immunocompromised hosts, the combination of REM and mAbs was associated with a significantly lower incidence of severe COVID-19 (aHR = 0.06, 95%CI = 0.02–0.77) when compared with monotherapy. Conclusions: REM and mAbs may reduce the risk of COVID-19 progression in hospitalized patients. Importantly, in immunocompromised hosts, the combination of mAbs and REM may be beneficial.</jats:p>", "alternative-id": [ "v15051199" ], "author": [ { "ORCID": "http://orcid.org/0000-0002-4833-7118", "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy" } ], "authenticated-orcid": false, "family": "Bavaro", "given": "Davide Fiore", "sequence": "first" }, { "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy" } ], "family": "Diella", "given": "Lucia", "sequence": "additional" }, { "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy" } ], "family": "Belati", "given": "Alessandra", "sequence": "additional" }, { "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy" } ], "family": "Metrangolo", "given": "Giuliana", "sequence": "additional" }, { "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy" } ], "family": "De Santis", "given": "Laura", "sequence": "additional" }, { "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy" } ], "family": "Spada", "given": "Vito", "sequence": "additional" }, { "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy" } ], "family": "Camporeale", "given": "Michele", "sequence": "additional" }, { "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy" } ], "family": "Dargenio", "given": "Angelo", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0001-7163-7437", "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy" } ], "authenticated-orcid": false, "family": "Brindicci", "given": "Gaetano", "sequence": "additional" }, { "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy" } ], "family": "Balena", "given": "Flavia", "sequence": "additional" }, { "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy" } ], "family": "Fiordelisi", "given": "Deborah", "sequence": "additional" }, { "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy" } ], "family": "Signorile", "given": "Fabio", "sequence": "additional" }, { "affiliation": [ { "name": "Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy" } ], "family": "Loseto", "given": "Giacomo", "sequence": "additional" }, { "affiliation": [ { "name": "Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy" } ], "family": "Pasciolla", "given": "Crescenza", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-5707-0689", "affiliation": [ { "name": "Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy" } ], "authenticated-orcid": false, "family": "Minoia", "given": "Carla", "sequence": "additional" }, { "affiliation": [ { "name": "Unit of Hematology and Stem Cell Transplantation, AOUC Policlinic, 70124 Bari, Italy" } ], "family": "Attolico", "given": "Immacolata", "sequence": "additional" }, { "affiliation": [ { "name": "Unit of Hematology and Stem Cell Transplantation, AOUC Policlinic, 70124 Bari, Italy" } ], "family": "Perrone", "given": "Tommasina", "sequence": "additional" }, { "affiliation": [ { "name": "Nephrology Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, Italy" } ], "family": "Simone", "given": "Simona", "sequence": "additional" }, { "affiliation": [ { "name": "Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy" } ], "family": "Rendina", "given": "Maria", "sequence": "additional" }, { "affiliation": [ { "name": "Hospital Pharmacy Department, University Hospital of Bari, 70124 Bari, Italy" } ], "family": "Giovine", "given": "Nicoletta", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0003-3453-5647", "affiliation": [ { "name": "Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Piazza G. 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