Real-World Use of Sotrovimab for Pre-Emptive Treatment in High-Risk Hospitalized COVID-19 Patients: An Observational Cross-Sectional Study
Ong et al.
, Real-World Use of Sotrovimab for Pre-Emptive Treatment in High-Risk Hospitalized COVID-19 Patients: An..
, Antibiotics, doi:10.3390/antibiotics11030345
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 US EUA has been revoked.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.
Real-World Use of Sotrovimab for Pre-Emptive Treatment in
High-Risk Hospitalized COVID-19 Patients: An Observational
Sean W. X. Ong 1,2 , Dongdong Ren 1,2 , Pei Hua Lee 1,2 , Stephanie Sutjipto 1,2 , Christopher Dugan 1,2 ,
Bo Yan Khoo 1,2 , Jun Xin Tay 1 , Shawn Vasoo 1,2,3 , Barnaby E. Young 1,2,3 and David C. Lye 1,2,3,4, *
Citation: Ong, S.W.X.; Ren, D.; Lee,
P.H.; Sutjipto, S.; Dugan, C.; Khoo,
B.Y.; Tay, J.X.; Vasoo, S.; Young, B.E.;
Lye, D.C. Real-World Use of
Sotrovimab for Pre-Emptive
Treatment in High-Risk Hospitalized
COVID-19 Patients: An
Observational Cross-Sectional Study.
Antibiotics 2022, 11, 345. https://
Academic Editors: Eleonora Nicolai
National Centre for Infectious Diseases, 16 Jln Tan Tock Seng, Singapore 308442, Singapore;
firstname.lastname@example.org (S.W.X.O.); email@example.com (D.R.); firstname.lastname@example.org (P.H.L.);
email@example.com (S.S.); firstname.lastname@example.org (C.D.);
email@example.com (B.Y.K.); firstname.lastname@example.org (J.X.T.); email@example.com (S.V.);
Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore 308433, Singapore
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
Correspondence: firstname.lastname@example.org; Tel.: +65-6357-7457
Abstract: 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.
and Mehran Monchi
Received: 11 February 2022
Keywords: COVID-19; SARS-CoV-2; sotrovimab; treatment; monoclonal antibody
Accepted: 3 March 2022
Published: 5 March 2022
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