Real-World Evidence of the Neutralizing Monoclonal Antibody Sotrovimab for Preventing Hospitalization and Mortality in COVID-19 Outpatients

It is not known whether sotrovimab, a neutralizing monoclonal antibody (mAb) treatment authorized for early symptomatic coronavirus disease 2019 (COVID-19) patients, is also effective in preventing the progression of severe disease and mortality following severe acute respiratory syndrome coronaviru...

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Bibliographic Details
Published in:The Journal of infectious diseases 2022-12, Vol.226 (12), p.2129-2136
Main Authors: Aggarwal, Neil R, Beaty, Laurel E, Bennett, Tellen D, Carlson, Nichole E, Davis, Christopher B, Kwan, Bethany M, Mayer, David A, Ong, Toan C, Russell, Seth, Steele, Jeffrey, Wogu, Adane F, Wynia, Matthew K, Zane, Richard D, Ginde, Adit A
Format: Article
Language:English
Subjects:
Adult
Antibodies, Monoclonal - therapeutic use
Antibodies, Neutralizing - therapeutic use
COVID-19
Hospitalization
Humans
Major
Outpatients
SARS-CoV-2
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Summary:It is not known whether sotrovimab, a neutralizing monoclonal antibody (mAb) treatment authorized for early symptomatic coronavirus disease 2019 (COVID-19) patients, is also effective in preventing the progression of severe disease and mortality following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant infection. In an observational cohort study of nonhospitalized adult patients with SARS-CoV-2 infection, 1 October 2021-11 December 2021, using electronic health records from a statewide health system plus state-level vaccine and mortality data, we used propensity matching to select 3 patients not receiving mAbs for each patient who received outpatient sotrovimab treatment. The primary outcome was 28-day hospitalization; secondary outcomes included mortality and severity of hospitalization. Of 10 036 patients with SARS-CoV-2 infection, 522 receiving sotrovimab were matched to 1563 not receiving mAbs. Compared to mAb-untreated patients, sotrovimab treatment was associated with a 63% decrease in the odds of all-cause hospitalization (raw rate 2.1% vs 5.7%; adjusted odds ratio [aOR], 0.37; 95% confidence interval [CI], .19-.66) and an 89% decrease in the odds of all-cause 28-day mortality (raw rate 0% vs 1.0%; aOR, 0.11; 95% CI, .0-.79), and may reduce respiratory disease severity among those hospitalized. Real-world evidence demonstrated sotrovimab effectiveness in reducing hospitalization and all-cause 28-day mortality among COVID-19 outpatients during the Delta variant phase.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/jiac206