Real-world effectiveness of sotrovimab in preventing hospitalization and mortality in high-risk patients with COVID-19 in the United States: A cohort study from the Mayo Clinic electronic health records
Christopher F Bell, Daniel C Gibbons, Myriam Drysdale, Helen J Birch, Emily J Lloyd, Vishal Patel, Corinne Carpenter, Katherine Carlson, Ediz S Calay, Arjun Puranik, Tyler E Wagner, John C O’horo, Raymund R Razonable
PLOS ONE, doi:10.1371/journal.pone.0304822
Background To describe outcomes of high-risk patients with coronavirus disease 2019 (COVID-19) treated with sotrovimab, other monoclonal antibodies (mAbs), or antivirals, and patients who did not receive early COVID-19 treatment. We also evaluate the comparative effectiveness of sotrovimab versus no treatment in preventing severe clinical outcomes.
Methods This observational retrospective cohort study analyzed Mayo Clinic electronic health records. Non-hospitalized adult patients diagnosed with COVID-19 from May 26, 2021 and April 23, 2022 and at high risk of COVID-19 progression were eligible. The primary outcome was 29-day all-cause hospitalization and/or death. Outcomes were described for patients treated with sotrovimab, other mAbs, or antivirals, and eligible but untreated patients, and compared between sotrovimab-treated and propensity score (PS)-matched untreated cohorts.
Results We included 35,485 patients (sotrovimab, 1369; other mAbs, 6488; antivirals, 133; high-risk untreated, 27,495). A low proportion of patients treated with sotrovimab (n = 33/1369, 2.4%), other mAbs (n = 147/6488, 2.3%), or antivirals (n = 2/133, 1.5%) experienced allcause hospitalization or death. Among high-risk untreated patients, the percentage of allcause hospitalization or death was 3.3% (n = 910/27,495). In the PS-matched analysis, 2.5% (n = 21/854) of sotrovimab-treated patients experienced all-cause hospitalization and/ or death versus 2.8% (n = 48/1708) of untreated patients (difference, -0.4%; p = 0.66).
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doi:10.1002/dmrr.3377{ 'indexed': {'date-parts': [[2024, 7, 17]], 'date-time': '2024-07-17T00:25:59Z', 'timestamp': 1721175959236},
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'abstract': '<jats:sec id="sec001">\n'
'<jats:title>Background</jats:title>\n'
'<jats:p>To describe outcomes of high-risk patients with coronavirus disease 2019 (COVID-19) '
'treated with sotrovimab, other monoclonal antibodies (mAbs), or antivirals, and patients who '
'did not receive early COVID-19 treatment. We also evaluate the comparative effectiveness of '
'sotrovimab versus no treatment in preventing severe clinical outcomes.</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec002">\n'
'<jats:title>Methods</jats:title>\n'
'<jats:p>This observational retrospective cohort study analyzed Mayo Clinic electronic health '
'records. Non-hospitalized adult patients diagnosed with COVID-19 from May 26, 2021 and April '
'23, 2022 and at high risk of COVID-19 progression were eligible. The primary outcome was '
'29-day all-cause hospitalization and/or death. Outcomes were described for patients treated '
'with sotrovimab, other mAbs, or antivirals, and eligible but untreated patients, and compared '
'between sotrovimab-treated and propensity score (PS)-matched untreated cohorts.</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec003">\n'
'<jats:title>Results</jats:title>\n'
'<jats:p>We included 35,485 patients (sotrovimab, 1369; other mAbs, 6488; antivirals, 133; '
'high-risk untreated, 27,495). A low proportion of patients treated with sotrovimab (n = '
'33/1369, 2.4%), other mAbs (n = 147/6488, 2.3%), or antivirals (n = 2/133, 1.5%) experienced '
'all-cause hospitalization or death. Among high-risk untreated patients, the percentage of '
'all-cause hospitalization or death was 3.3% (n = 910/27,495). In the PS-matched analysis, '
'2.5% (n = 21/854) of sotrovimab-treated patients experienced all-cause hospitalization and/or '
'death versus 2.8% (n = 48/1708) of untreated patients (difference, –0.4%; p = 0.66). '
'Significantly fewer sotrovimab-treated patients required intensive care unit admission (0.5% '
'vs 1.8%; difference, –1.3%; p = 0.002) or respiratory support (3.5% vs 8.7%; difference, '
'–5.2%; p < 0.001).</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec004">\n'
'<jats:title>Conclusions</jats:title>\n'
'<jats:p>There was no significant difference in the proportion of sotrovimab-treated and '
'PS-matched untreated patients experiencing 29-day all-cause hospitalization or mortality, '
'although significantly fewer sotrovimab-treated patients required intensive care unit '
'admission or respiratory support.</jats:p>\n'
'</jats:sec>',
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