Real-World Use of Sotrovimab for Pre-Emptive Treatment in High-Risk Hospitalized COVID-19 Patients: An Observational Cross-Sectional Study
Sean W X Ong, Dongdong Ren, Pei Hua Lee, Stephanie Sutjipto, Christopher Dugan, Bo Yan Khoo, Jun Xin Tay, Shawn Vasoo, Barnaby E Young, David C Lye
Antibiotics, doi:10.3390/antibiotics11030345
Data on use of monoclonal antibodies (mAbs) in hospitalized patients are limited. In this cross-sectional study, we evaluated the use of mAbs for early treatment of unvaccinated hospitalized patients with mild-to-moderate COVID-19. All inpatients at our center were screened on 27 October 2021. Primary outcome was in-hospital deterioration as defined by a composite of oxygen requirement, intensive care unit (ICU) admission, or mortality within 28 days of admission. Ninety-four out of 410 COVID-19 inpatients were included in the final analysis, of whom 19 (20.2%) received early treatment with sotrovimab. The median age was 73 years (IQR 61-83), and 35 (37.2%) were female. Although the treatment group was significantly older and had more comorbidities, there was a lower proportion of progression to oxygen requirement (31.6% vs. 54.7%), ICU admission (10.5% vs. 24.0%), or mortality (5.3% vs. 13.3%). Kaplan-Meier curves showed a significant difference in time to in-hospital deterioration (log-rank test, p = 0.043). Cox proportional hazards model for in-hospital deterioration showed that sotrovimab treatment was protective (hazard ratio, 0.41; 95% CI, 0.17-0.99; p = 0.047) after adjustment for baseline ISARIC deterioration score. Our findings support the use of sotrovimab for early treatment in hospitalized patients with mild-to-moderate COVID-19 at a high risk of disease progression.
Informed Consent Statement: Patient consent was waived as approved by the institutional ethics committee for retrospective data collection without collection of individually identifiable patient identifiers.
Data Availability Statement: The data presented in this study are available upon request from the corresponding author.
Conflicts of Interest: BEY reports personal fees from Roche and Sanofi outside the submitted work. All other authors declare no competing interest.
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