Comparative effectiveness of sotrovimab versus no treatment in non-hospitalised high-risk COVID-19 patients in north west London: a retrospective cohort study

• Published in: BMJ open respiratory research Vol. 11; no. 1; p. e002238
• Main Authors: Drysdale, Myriam, Galimov, Evgeniy R, Yarwood, Marcus James, Patel, Vishal, Levick, Bethany, Gibbons, Daniel C, Watkins, Jonathan D, Young, Sophie, Pierce, Benjamin F, Lloyd, Emily J, Kerr, William, Birch, Helen J, Kamalati, Tahereh, Brett, Stephen J
• Format: Journal Article
• Language: English
• Published: England British Thoracic Society 04.04.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Acquired immune deficiency syndrome; AIDS; Antibodies, Monoclonal, Humanized; Antibodies, Neutralizing; Antiviral drugs; Cancer; Clinical trials; Cohort analysis; Comorbidity; COVID-19; COVID-19 Drug Treatment; COVID-19 vaccines; Datasets; Ethnicity; Hematology; HIV; Hospitalization; Human immunodeficiency virus; Humans; Kidney diseases; Kidney transplants; Liver diseases; London - epidemiology; Monoclonal antibodies; Patients; Respiratory Infection; Retrospective Studies; Severe acute respiratory syndrome coronavirus 2; State Medicine; Viral infection; London; United Kingdom > UK; England; COVID-19; Viral infection; Respiratory Infection
• ISSN: 2052-4439; 2052-4439
• DOI: 10.1136/bmjresp-2023-002238

BackgroundWe assessed the effectiveness of sotrovimab vs no early COVID-19 treatment in highest-risk COVID-19 patients during Omicron predominance.MethodsRetrospective cohort study using the Discover dataset in North West London. Included patients were non-hospitalised, aged ≥12 years and met ≥1 National Health Service highest-risk criterion for sotrovimab treatment. We used Cox proportional hazards models to compare HRs of 28-day COVID-19-related hospitalisation/death between highest-risk sotrovimab-treated and untreated patients. Age, renal disease and Omicron subvariant subgroup analyses were performed.ResultsWe included 599 sotrovimab-treated patients and 5191 untreated patients. Compared with untreated patients, the risk of COVID-19 hospitalisation/death (HR 0.50, 95% CI 0.24, 1.06; p=0.07) and the risk of COVID-19 hospitalisation (HR 0.43, 95% CI 0.18, 1.00; p=0.051) were both lower in the sotrovimab-treated group; however, statistical significance was not reached. In the ≥65 years and renal disease subgroups, sotrovimab was associated with a significantly reduced risk of COVID-19 hospitalisation, by 89% (HR 0.11, 95% CI 0.02, 0.82; p=0.03) and 82% (HR 0.18, 95% CI 0.05, 0.62; p=0.007), respectively.ConclusionsRisk of COVID-19 hospitalisation in sotrovimab-treated patients aged ≥65 years and with renal disease was significantly lower compared with untreated patients. Overall, risk of hospitalisation was also lower for sotrovimab-treated patients, but statistical significance was not reached.