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0 0.5 1 1.5 2+ Mortality 61% Improvement Relative Risk ICU admission 56% Progression 59% Sotrovimab for COVID-19  Ong et al.  EARLY TREATMENT Is early treatment with sotrovimab beneficial for COVID-19? Retrospective 94 patients in Singapore Lower progression with sotrovimab (p=0.047) Ong et al., Antibiotics, March 2022 Favors sotrovimab Favors control

Real-World Use of Sotrovimab for Pre-Emptive Treatment in High-Risk Hospitalized COVID-19 Patients: An Observational Cross-Sectional Study

Ong et al., Antibiotics, doi:10.3390/antibiotics11030345
Mar 2022  
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Retrospective 19 sotrovimab patients and 75 controls is Singapore, showing lower progression with treatment.
Efficacy is variant dependent. In Vitro studies predict lower efficacy for BA.1 Liu, Sheward, VanBlargan and a lack of efficacy for BA.2 Zhou. US EUA has been revoked.
risk of death, 60.5% lower, RR 0.39, p = 0.45, treatment 1 of 19 (5.3%), control 10 of 75 (13.3%), NNT 12.
risk of ICU admission, 56.1% lower, RR 0.44, p = 0.35, treatment 2 of 19 (10.5%), control 18 of 75 (24.0%), NNT 7.4.
risk of progression, 59.0% lower, HR 0.41, p = 0.047, treatment 19, control 75, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ong et al., 5 Mar 2022, retrospective, Singapore, peer-reviewed, 10 authors, average treatment delay 2.0 days.
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This PaperSotrovimabAll
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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