Early combination of sotrovimab with nirmatrelvir/ritonavir or remdesivir is associated with low rate of persisting SARS CoV-2 infection in immunocompromised outpatients with mild-to-moderate COVID-19: a prospective single-centre study.

Annals of medicine Pub Date : 2025-12-01 Epub Date: 2024-12-11 DOI:10.1080/07853890.2024.2439541
I Gentile, G Viceconte, F Cuccurullo, D Pietroluongo, A D'Agostino, M Silvitelli, S Mercinelli, R Scotto, F Grimaldi, S Palmieri, A Gravetti, F Trastulli, M Moccia, A R Buonomo
{"title":"Early combination of sotrovimab with nirmatrelvir/ritonavir or remdesivir is associated with low rate of persisting SARS CoV-2 infection in immunocompromised outpatients with mild-to-moderate COVID-19: a prospective single-centre study.","authors":"I Gentile, G Viceconte, F Cuccurullo, D Pietroluongo, A D'Agostino, M Silvitelli, S Mercinelli, R Scotto, F Grimaldi, S Palmieri, A Gravetti, F Trastulli, M Moccia, A R Buonomo","doi":"10.1080/07853890.2024.2439541","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Immunocompromised patients are at high risk of developing persisting/prolonged COVID-19. Data on the early combined use of antivirals and monoclonal antibodies in this population are scarce.</p><p><strong>Research design and methods: </strong>We performed an observational, prospective study, enrolling immunocompromised outpatients with mild-to-moderate COVID-19, treated with a combination of sotrovimab plus one antiviral (remdesivir or nirmatrelvir/ritonavir) within 7 days from symptom onset. Primary outcome was hospitalization within 30 days. Secondary outcomes were: needing for oxygen therapy; development of persistent infection; death within 60 days and reinfection or relapse within 90 days.</p><p><strong>Results: </strong>We enrolled 52 patients. No patient was hospitalized within 30 days of disease onset, required oxygen administration, died within 60 days, or experienced a reinfection or clinical relapse within 90 days.The clearance rates were 67% and 97% on the 14th day after the end of therapy and at the end of the follow-up period, respectively.Factors associated with longer infection were initiation of therapy 3 days after symptom onset and enrollment for more than 180 days from the beginning of the study. However, only the latter factor was independently associated with a longer SARS-CoV-2 infection, suggesting a loss of efficacy of this strategy with the evolution of SARS-CoV-2 variants.</p><p><strong>Conclusions: </strong>Early administration of combination therapy with a direct antiviral and sotrovimab seems to be effective in preventing hospitalization, progression to severe COVID-19, and development of prolonged/persisting SARS-CoV-2 infection in immunocompromised patients.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2439541"},"PeriodicalIF":0.0000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636137/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/07853890.2024.2439541","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/11 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Immunocompromised patients are at high risk of developing persisting/prolonged COVID-19. Data on the early combined use of antivirals and monoclonal antibodies in this population are scarce.

Research design and methods: We performed an observational, prospective study, enrolling immunocompromised outpatients with mild-to-moderate COVID-19, treated with a combination of sotrovimab plus one antiviral (remdesivir or nirmatrelvir/ritonavir) within 7 days from symptom onset. Primary outcome was hospitalization within 30 days. Secondary outcomes were: needing for oxygen therapy; development of persistent infection; death within 60 days and reinfection or relapse within 90 days.

Results: We enrolled 52 patients. No patient was hospitalized within 30 days of disease onset, required oxygen administration, died within 60 days, or experienced a reinfection or clinical relapse within 90 days.The clearance rates were 67% and 97% on the 14th day after the end of therapy and at the end of the follow-up period, respectively.Factors associated with longer infection were initiation of therapy 3 days after symptom onset and enrollment for more than 180 days from the beginning of the study. However, only the latter factor was independently associated with a longer SARS-CoV-2 infection, suggesting a loss of efficacy of this strategy with the evolution of SARS-CoV-2 variants.

Conclusions: Early administration of combination therapy with a direct antiviral and sotrovimab seems to be effective in preventing hospitalization, progression to severe COVID-19, and development of prolonged/persisting SARS-CoV-2 infection in immunocompromised patients.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
一项前瞻性单中心研究表明,在患有轻中度COVID-19的免疫功能低下门诊患者中,sotrovimab与尼马特利韦/利托那韦或瑞德西韦的早期联合用药与持续低SARS CoV-2感染率相关。
背景:免疫功能低下患者发展为持续/长期COVID-19的风险很高。在这一人群中早期联合使用抗病毒药物和单克隆抗体的数据很少。研究设计和方法:我们进行了一项观察性、前瞻性研究,纳入了轻至中度COVID-19免疫功能低下的门诊患者,这些患者在症状出现后7天内联合使用sotrovimab加一种抗病毒药物(remdesivir或nirmatrelvir/ritonavir)治疗。主要结局为30天内住院。次要结局是:需要吸氧治疗;持续感染的发展;60天内死亡,90天内再感染或复发。结果:我们入组了52例患者。没有患者在发病30天内住院,没有患者需要给氧,没有患者在60天内死亡,没有患者在90天内再次感染或临床复发。治疗结束后第14天和随访结束时,清除率分别为67%和97%。与感染时间延长相关的因素是在症状出现后3天开始治疗,以及从研究开始入组超过180天。然而,只有后一个因素与更长时间的SARS-CoV-2感染独立相关,这表明该策略随着SARS-CoV-2变体的进化而失去效力。结论:免疫功能低下患者早期给予直接抗病毒药物和索罗维单抗联合治疗似乎可有效预防住院、进展为严重COVID-19以及长期/持续的SARS-CoV-2感染。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Evaluating the efficacy and safety of polyglycolic acid-loading mitomycin nanoparticles in inhibiting the scar proliferation after glaucoma filtering surgery. Development and application of an uncapped mRNA platform. Overexpression of ST8Sia1 inhibits tumor progression by TGF-β1 signaling in rectal adenocarcinoma and promotes the tumoricidal effects of CD8+ T cells by granzyme B and perforin. Early combination of sotrovimab with nirmatrelvir/ritonavir or remdesivir is associated with low rate of persisting SARS CoV-2 infection in immunocompromised outpatients with mild-to-moderate COVID-19: a prospective single-centre study. Prognostic indicators and outcome in patients with acute liver failure, sepsis and with and without shock: a retrospective cohort study.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1