Sipavibart: meta-analysis of COVID-19 studies

Meta-analysis of sipavibart COVID-19 studies. mAb use may create new variants that spread globally1-3, and may be associated with increased risk of autoimmune disease4, prolonged viral loads, clinical deterioration, and immune escape2,5-9.

All studies Mortality Serious outcomes Cases RCTs RCT mortality Peer-reviewed All outcomes

Outcome (studies)

Improvement

Relative risk · 95% CI

All studies (2)−132%

Mortality (2)−132%

Cases (1)33%

RCTs (2)−132%

RCT mortality (2)−132%

Peer-reviewed (1)−124%

Prophylaxis (2)−132%

00.511.5+

← Sipavibart
reduces riskIncreased
risk →

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c19early.org

October 2026

Sipavibart COVID-19 studies

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

AstraZen.. (DB RCT)−267%3.67 · 0.18–74.24death2/870/29NOVELLA Haidar (DB RCT)−124%2.24 · 0.95–5.25death40/1,6716/561SUPERNOVA

Prophylaxis−132%2.32 · 1.02–5.2742/1,7586/590132% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.044

All studies−132%2.32 · 1.02–5.2742/1,7586/590132% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.04400.511.52+

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← Sipavibart
reduces riskSipavibart
increases risk →

c19early.org

October 2026

Sipavibart COVID-19 mortality results

StudyImprovementRR · 95% CITreatmentControlRelative Risk

AstraZen.. (DB RCT)−267%3.67 · 0.18–74.242/870/29NOVELLA Haidar (DB RCT)−124%2.24 · 0.95–5.2540/1,6716/561SUPERNOVA

Prophylaxis−132%2.32 · 1.02–5.2742/1,7586/590132% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.044

All studies−132%2.32 · 1.02–5.2742/1,7586/590132% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.04400.511.52+

Rotate screen for more detailsIncrease width for more details

← Sipavibart
reduces riskSipavibart
increases risk →

c19early.org

October 2026

Sipavibart COVID-19 serious outcomes

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

AstraZen.. (DB RCT)−267%3.67 · 0.18–74.24death2/870/29NOVELLA Haidar (DB RCT)−124%2.24 · 0.95–5.25death40/1,6716/561SUPERNOVA

Prophylaxis−132%2.32 · 1.02–5.2742/1,7586/590132% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.044

All studies−132%2.32 · 1.02–5.2742/1,7586/590132% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.04400.511.52+

Rotate screen for more detailsIncrease width for more details

← Sipavibart
reduces riskSipavibart
increases risk →

c19early.org

October 2026

Sipavibart COVID-19 case results

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

AstraZen.. (DB RCT)33%0.67 · 0.13–3.45symp. case4/872/29NOVELLA

Prophylaxis33%0.67 · 0.13–3.454/872/2933% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.64

All studies33%0.67 · 0.13–3.454/872/2933% lower risk

Tau² = 0.00, I² = 0.0%, p = 0.6400.511.52+

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← Sipavibart
reduces riskSipavibart
increases risk →

c19early.org

October 2026

Sipavibart COVID-19 Randomized Controlled Trials

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

AstraZen.. (DB RCT)−267%3.67 · 0.18–74.24death2/870/29NOVELLA Haidar (DB RCT)−124%2.24 · 0.95–5.25death40/1,6716/561SUPERNOVA

Prophylaxis−132%2.32 · 1.02–5.2742/1,7586/590132% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.044

All studies−132%2.32 · 1.02–5.2742/1,7586/590132% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.04400.511.52+

Rotate screen for more detailsIncrease width for more details

← Sipavibart
reduces riskSipavibart
increases risk →

c19early.org

October 2026

Sipavibart COVID-19 RCT mortality results

StudyImprovementRR · 95% CITreatmentControlRelative Risk

AstraZen.. (DB RCT)−267%3.67 · 0.18–74.242/870/29NOVELLA Haidar (DB RCT)−124%2.24 · 0.95–5.2540/1,6716/561SUPERNOVA

Prophylaxis−132%2.32 · 1.02–5.2742/1,7586/590132% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.044

All studies−132%2.32 · 1.02–5.2742/1,7586/590132% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.04400.511.52+

Rotate screen for more detailsIncrease width for more details

← Sipavibart
reduces riskSipavibart
increases risk →

c19early.org

October 2026

Sipavibart COVID-19 peer reviewed studies

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Haidar (DB RCT)−124%2.24 · 0.95–5.25death40/1,6716/561SUPERNOVA

Prophylaxis−124%2.24 · 0.95–5.2540/1,6716/561124% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.064

All studies−124%2.24 · 0.95–5.2540/1,6716/561124% higher risk

Tau² = 0.00, I² = 0.0%, p = 0.06400.511.52+

Rotate screen for more detailsIncrease width for more details

← Sipavibart
reduces riskSipavibart
increases risk →

c19early.org

October 2026

Sipavibart COVID-19 outcomes

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

AstraZen.. (DB RCT)−267%3.67 · 0.18–74.24death2/870/29NOVELLA AstraZen.. (DB RCT)33%0.67 · 0.13–3.45symp. case4/872/29NOVELLA Haidar (DB RCT)−124%2.24 · 0.95–5.25death40/1,6716/561SUPERNOVA Haidar (DB RCT)−236%3.36 · 0.79–14.32death20/1,6712/561SUPERNOVA

00.511.52+

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← Sipavibart
reduces riskSipavibart
increases risk →

References

Focosi et al., Analysis of SARS-CoV-2 mutations associated with resistance to therapeutic monoclonal antibodies that emerge after treatment, Drug Resistance Updates, doi:10.1016/j.drup.2023.100991.sciencedirect.com, doi.org.

Leducq et al., Spike protein genetic evolution in patients at high-risk of severe COVID-19 treated by monoclonal antibodies, The Journal of Infectious Diseases, doi:10.1093/infdis/jiad523.oup.com, doi.org.

Bruhn et al., Somatic hypermutation shapes the viral escape profile of SARS-CoV-2 neutralising antibodies, eBioMedicine, doi:10.1016/j.ebiom.2025.105770.sciencedirect.com, doi.org.

Ngiam et al., Early administration of neutralising monoclonal antibodies and post-acute sequelae of COVID-19, International Journal of Infectious Diseases, doi:10.1016/j.ijid.2026.108435.sciencedirect.com, doi.org.

Choudhary et al., Emergence of SARS-CoV-2 Resistance with Monoclonal Antibody Therapy, medRxiv, doi:10.1101/2021.09.03.21263105.medrxiv.org, doi.org.

Günther et al., Variant-specific humoral immune response to SARS-CoV-2 escape mutants arising in clinically severe, prolonged infection, medRxiv, doi:10.1101/2024.01.06.24300890.medrxiv.org, doi.org.

Casadevall et al., Single monoclonal antibodies should not be used for COVID-19 therapy: a call for antiviral stewardship, Clinical Infectious Diseases, doi:10.1093/cid/ciae408.oup.com, doi.org.

Focosi (B) et al., The Emergence of Escape Mutations in COVID-19 Following Anti-Spike Monoclonal Antibody Treatment: How Do We Tackle It?, Infection and Drug Resistance, doi:10.2147/IDR.S540928.dovepress.com, doi.org.

Martin-Blondel et al., Viral clearance and escape during therapy of COVID-19 outpatients: A prospective cohort study, iScience, doi:10.1016/j.isci.2025.114226.sciencedirect.com, doi.org.