ABSTRACT
Background: Oral antivirals (nirmatrelvir/ritonavir and molnupiravir), intravenous short treatment of remdesivir and anti-SARS-CoV-2 monoclonal antibodies (mAbs) have been used for early COVID-19 treatments in high risk of disease progression patients. Little is known about the impact of therapies on post-acute COVID-19 (PACS). We aimed to compare the efficacy of these therapies in terms of death, hospitalization rate and PACS at 3 months. Method(s): We conducted a retrospective observational study including all eligible outpatients aged >=18 evaluated from April 2021 to March 2022 at our COVID-19 Clinic. Patients were stratified into 3 groups: mAbs, antivirals (oral and short-course remdesivir) and controls (eligible patients who refused treatment). Persistence of symptoms (fever, dysgeusia/anosmia, cough, pharyngodynia, dyspnea, chills, nasal congestion, myalgia, headache, gastrointestinal disease, and neuro-behavioural symptoms, such as asthenia, anxiety/mood disorder, memory and concentration deficit) were evaluated after 3 months. We estimated the associations between each considered outcome and treatment through univariate and multivariable logistic models adjusted by sex, age, vaccination, early COVID treatment, treatment group and number of comorbidities (when appropriate). Result(s): We included 649 patients (51.6% males, median age 67 years, 14% unvaccinated): 242 patients were treated with mAbs, 197 with antivirals and 210 received no treatment. Overall, 36.7% of subjects had cerebro-cardiovascular disease, 22% were obese and 50% had more than one comorbidity. Overall, 29 patients (4.5%) died or were hospitalized. Death or hospitalization was positively associated only with older ages with a significant linear trend (p for trend: 0.033). Data on PACS at 3 months were available for 323 (49.8%) patients. Females showed a positive association with long COVID, with an OR of 2.14 (95% CI: 1.30-3.53) as compared to men. Patients treated with antiviral drugs showed an inverse association with long COVID (OR: 0.43, 95% CI: 0.21-0.87 as compared to not treated patients). Patients who were treated with monoclonal antibodies showed an OR of 0.48 (95% CI: 0.25-0.92) as compared to those in the control group (Table 1). Conclusion(s): The impact of early COVID-19 therapies on PACS is unknown. Our results showed that these treatments, in particular mAbs, can reduce persistence of neuro-behavioural symptoms at 3 months. (Table Presented).
ABSTRACT
Little is known about the clinical outcomes of patients with human immunodeficiency virus infected with SARS-CoV-2. We describe 47 patients referred to our hospital between 21 February and 16 April 2020 with proven/probable COVID-19, 45 (96%) of whom fully recovered and 2 who died. © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.