Division of Infectious Diseases, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Transplant Infectious Diseases and Ajmera Transplant Centre, University Health Network, 585 University Avenue, MaRS Building, 9th Floor, Toronto, ON, M5G 2N2, Canada.
BMC Res Notes. 2024 Jan 24;17(1):37. doi: 10.1186/s13104-024-06695-x.
In vitro data suggested reduced neutralizing capacity of sotrovimab, a monoclonal antibody, against Omicron BA.2 subvariant. However, limited in vivo data exist regarding clinical effectiveness of sotrovimab for coronavirus disease 2019 (COVID-19) due to Omicron BA.2.
A multicentre, retrospective cohort study was conducted at three Canadian academic tertiary centres. Electronic medical records were reviewed for patients ≥ 18 years with mild COVID-19 (sequencing-confirmed Omicron BA.1 or BA.2) treated with sotrovimab between February 1 to April 1, 2022. Thirty-day co-primary outcomes included hospitalization due to moderate or severe COVID-19; all-cause intensive care unit (ICU) admission, and all-cause mortality. Risk differences (BA.2 minus BA.1 group) for co-primary outcomes were adjusted with propensity score matching (e.g., age, sex, vaccination, immunocompromised status).
Eighty-five patients were included (15 BA.2, 70 BA.1) with similar baseline characteristics between groups. Adjusted risk differences were non-statistically significant between groups for 30-day hospitalization (- 14.3%; 95% confidence interval (CI): - 32.6 to 4.0%), ICU admission (- 7.1%; 95%CI: - 20.6 to 6.3%), and mortality (- 7.1%; 95%CI: - 20.6 to 6.3%).
No differences were demonstrated in hospitalization, ICU admission, or mortality rates within 30 days between sotrovimab-treated patients with BA.1 versus BA.2 infection. More real-world data may be helpful to properly assess sotrovimab's effectiveness against infections due to specific emerging COVID-19 variants.
体外数据表明，单克隆抗体 sotrovimab 对奥密克戎 BA.2 亚变体的中和能力降低。然而，由于奥密克戎 BA.2，关于 sotrovimab 治疗 2019 年冠状病毒病（COVID-19）的临床效果的体内数据有限。
在加拿大三个学术三级中心进行了一项多中心、回顾性队列研究。对 2022 年 2 月 1 日至 4 月 1 日期间接受 sotrovimab 治疗的轻度 COVID-19（经测序证实为奥密克戎 BA.1 或 BA.2）的患者≥18 岁的电子病历进行了回顾。30 天的主要复合结局包括因中度或重度 COVID-19 住院；入住重症监护病房（ICU）和全因死亡率。使用倾向评分匹配（例如年龄、性别、疫苗接种、免疫功能低下状态）调整主要复合结局的风险差异（BA.2 组与 BA.1 组）。
共纳入 85 例患者（15 例 BA.2，70 例 BA.1），两组患者的基线特征相似。两组 30 天住院率（-14.3%；95%置信区间（CI）：-32.6 至 4.0%）、ICU 入院率（-7.1%；95%CI：-20.6 至 6.3%）和死亡率（-7.1%；95%CI：-20.6 至 6.3%）的调整风险差异无统计学意义。
BA.1 与 BA.2 感染的 sotrovimab 治疗患者在 30 天内的住院、ICU 入院或死亡率无差异。更多的真实世界数据可能有助于正确评估 sotrovimab 对特定新型 COVID-19 变体感染的有效性。
