tetano
Editor, Senior Moderator
NPJ Prim Care Respir Med
. 2024 Jun 28;34(1):17.
doi: 10.1038/s41533-024-00374-x. Real-world severe COVID-19 outcomes associated with use of antivirals and neutralising monoclonal antibodies in Scotland
Holly Tibble[SUP] 1 2 [/SUP], Tanja Mueller[SUP] 3 4 [/SUP], Euan Proud[SUP] 3 [/SUP], Elliott Hall[SUP] 3 [/SUP], Amanj Kurdi[SUP] 3 4 5 6 [/SUP], Chris Robertson[SUP] 3 7 [/SUP], Marion Bennie[SUP] 3 4 [/SUP], Lana Woolford[SUP] 8 3 [/SUP], Lynn Laidlaw[SUP] 9 [/SUP], Kamil Sterniczuk[SUP] 9 [/SUP], Aziz Sheikh[SUP] 8 [/SUP]
Affiliations
We sought to investigate the incidence of severe COVID-19 outcomes after treatment with antivirals and neutralising monoclonal antibodies, and estimate the comparative effectiveness of treatments in community-based individuals. We conducted a retrospective cohort study investigating clinical outcomes of hospitalisation, intensive care unit admission and death, in those treated with antivirals and monoclonal antibodies for COVID-19 in Scotland between December 2021 and September 2022. We compared the effect of various treatments on the risk of severe COVID-19 outcomes, stratified by most prevalent sub-lineage at that time, and controlling for comorbidities and other patient characteristics. We identified 14,365 individuals treated for COVID-19 during our study period, some of whom were treated for multiple infections. The incidence of severe COVID-19 outcomes (inpatient admission or death) in community-treated patients (81% of all treatment episodes) was 1.2% (n = 137/11894, 95% CI 1.0-1.4), compared to 32.8% in those treated in hospital for acute COVID-19 (re-admissions or death; n = 40/122, 95% CI 25.1-41.5). For community-treated patients, there was a lower risk of severe outcomes (inpatient admission or death) in younger patients, and in those who had received three or more COVID-19 vaccinations. During the period in which BA.2 was the most prevalent sub-lineage in the UK, sotrovimab was associated with a reduced treatment effect compared to nirmaltrelvir + ritonavir. However, since BA.5 has been the most prevalent sub-lineage in the UK, both sotrovimab and nirmaltrelvir + ritonavir were associated with similarly lower incidence of severe outcomes than molnupiravir. Around 1% of those treated for COVID-19 with antivirals or neutralising monoclonal antibodies required hospital admission. During the period in which BA.5 was the prevalent sub-lineages in the UK, molnupiravir was associated with the highest incidence of severe outcomes in community-treated patients.
. 2024 Jun 28;34(1):17.
doi: 10.1038/s41533-024-00374-x. Real-world severe COVID-19 outcomes associated with use of antivirals and neutralising monoclonal antibodies in Scotland
Holly Tibble[SUP] 1 2 [/SUP], Tanja Mueller[SUP] 3 4 [/SUP], Euan Proud[SUP] 3 [/SUP], Elliott Hall[SUP] 3 [/SUP], Amanj Kurdi[SUP] 3 4 5 6 [/SUP], Chris Robertson[SUP] 3 7 [/SUP], Marion Bennie[SUP] 3 4 [/SUP], Lana Woolford[SUP] 8 3 [/SUP], Lynn Laidlaw[SUP] 9 [/SUP], Kamil Sterniczuk[SUP] 9 [/SUP], Aziz Sheikh[SUP] 8 [/SUP]
Affiliations
- PMID: 38942748
- PMCID: PMC11213868
- DOI: 10.1038/s41533-024-00374-x
We sought to investigate the incidence of severe COVID-19 outcomes after treatment with antivirals and neutralising monoclonal antibodies, and estimate the comparative effectiveness of treatments in community-based individuals. We conducted a retrospective cohort study investigating clinical outcomes of hospitalisation, intensive care unit admission and death, in those treated with antivirals and monoclonal antibodies for COVID-19 in Scotland between December 2021 and September 2022. We compared the effect of various treatments on the risk of severe COVID-19 outcomes, stratified by most prevalent sub-lineage at that time, and controlling for comorbidities and other patient characteristics. We identified 14,365 individuals treated for COVID-19 during our study period, some of whom were treated for multiple infections. The incidence of severe COVID-19 outcomes (inpatient admission or death) in community-treated patients (81% of all treatment episodes) was 1.2% (n = 137/11894, 95% CI 1.0-1.4), compared to 32.8% in those treated in hospital for acute COVID-19 (re-admissions or death; n = 40/122, 95% CI 25.1-41.5). For community-treated patients, there was a lower risk of severe outcomes (inpatient admission or death) in younger patients, and in those who had received three or more COVID-19 vaccinations. During the period in which BA.2 was the most prevalent sub-lineage in the UK, sotrovimab was associated with a reduced treatment effect compared to nirmaltrelvir + ritonavir. However, since BA.5 has been the most prevalent sub-lineage in the UK, both sotrovimab and nirmaltrelvir + ritonavir were associated with similarly lower incidence of severe outcomes than molnupiravir. Around 1% of those treated for COVID-19 with antivirals or neutralising monoclonal antibodies required hospital admission. During the period in which BA.5 was the prevalent sub-lineages in the UK, molnupiravir was associated with the highest incidence of severe outcomes in community-treated patients.