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Real-world effectiveness of sotrovimab and remdesivir for early treatment of high-risk hospitalized COVID-19 patients: A propensity score adjusted retrospective cohort study.
Koh, Lin Pin; Chua, Siang Li; Vasoo, Shawn; Toh, Matthias Paul Han Sim; Cutter, Jeremy Nicholas; Nah, Puay Hoon; Leo, Yee-Sin; Tay, Jun Xin; Young, Barnaby Edward; Lye, David C; Ong, Sean W X.
  • Koh LP; National Centre for Infectious Diseases, Singapore, Singapore.
  • Chua SL; Anglo-Chinese School (Independent), Singapore, Singapore.
  • Vasoo S; National Centre for Infectious Diseases, Singapore, Singapore.
  • Toh MPHS; National Centre for Infectious Diseases, Singapore, Singapore.
  • Cutter JN; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore.
  • Nah PH; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
  • Leo YS; National Centre for Infectious Diseases, Singapore, Singapore.
  • Tay JX; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
  • Young BE; National Centre for Infectious Diseases, Singapore, Singapore.
  • Lye DC; National Centre for Infectious Diseases, Singapore, Singapore.
  • Ong SWX; National Centre for Infectious Diseases, Singapore, Singapore.
J Med Virol ; 95(2): e28460, 2023 02.
Article in English | MEDLINE | ID: covidwho-2173228
ABSTRACT
Early treatment of high-risk COVID-19 patients may prevent disease progression. However, there are limited data to support treatment of hospitalized or fully vaccinated patients with mild-to-moderate disease. In this retrospective cohort study, we studied the effect of early use of sotrovimab and remdesivir in high-risk hospitalized COVID-19 patients. We included PCR-confirmed COVID-19 patients admitted to the National Centre for Infectious Diseases who presented within the first 5 days of illness, and who were not requiring oxygen or ICU care at presentation. Sotrovimab- and remdesivir-treated groups were compared with control (no early treatment). A multiple propensity-score adjusted multivariable regression analysis was conducted with a composite primary endpoint of in-hospital deterioration (oxygen requirement, ICU admission, or mortality). Of 1118 patients, 841 were in the control group, 106 in the sotrovimab group and 169 in the remdesivir group. The median age was 63 years (IQR 46-74 years) and 505 (45.2%) were female. In unvaccinated patients, both remdesivir and sotrovimab treatment were protective (adjusted odds ratio [aOR] 0.19, 95% CI 0.064-0.60 and 0.18 [95% CI 0.066-0.47]), respectively. Contrarily, among the vaccinated patients there was no significant treatment effect with early remdesivir treatment (aOR 2.51, 95% CI 0.83-7.57, p = 0.10). Remdesivir and sotrovimab treatment, given early in the disease course to unvaccinated high-risk patients, was effective in reducing the risk of in-hospital deterioration and severe disease. This effect was not seen in fully vaccinated patients, which may be due to a small sample size or residual confounding.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Female / Humans / Male / Middle aged Language: English Journal: J Med Virol Year: 2023 Document Type: Article Affiliation country: Jmv.28460

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Female / Humans / Male / Middle aged Language: English Journal: J Med Virol Year: 2023 Document Type: Article Affiliation country: Jmv.28460