GSK, Brentford, UK
Imperial College Health Partners, London, UK.
BMJ Open Respir Res. 2024 Apr 4;11(1):e002238. doi: 10.1136/bmjresp-2023-002238.
We assessed the effectiveness of sotrovimab vs no early COVID-19 treatment in highest-risk COVID-19 patients during Omicron predominance.
Retrospective 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.
We 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.
Risk 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.
我们评估了在奥密克戎为主的时期，索特罗维单抗对最高危新冠患者早期新冠治疗的有效性。
这是一项在伦敦西北部的发现数据库中进行的回顾性队列研究。纳入的患者为非住院、年龄≥12 岁且符合索特罗维单抗治疗的国家卫生服务系统最高风险标准之一。我们使用 Cox 比例风险模型比较了最高危索特罗维单抗治疗组和未治疗组 28 天内新冠相关住院/死亡的 HR。进行了年龄、肾脏疾病和奥密克戎亚变异亚组分析。
我们纳入了 599 名接受索特罗维单抗治疗的患者和 5191 名未接受治疗的患者。与未治疗的患者相比，索特罗维单抗治疗组的新冠住院/死亡风险（HR 0.50，95%CI 0.24，1.06；p=0.07）和新冠住院风险（HR 0.43，95%CI 0.18，1.00；p=0.051）均较低，但未达到统计学意义。在≥65 岁和肾脏疾病亚组中，索特罗维单抗与新冠住院风险显著降低相关，分别降低 89%（HR 0.11，95%CI 0.02，0.82；p=0.03）和 82%（HR 0.18，95%CI 0.05，0.62；p=0.007）。
与未治疗的患者相比，年龄≥65 岁和患有肾脏疾病的索特罗维单抗治疗患者的新冠住院风险显著降低。总体而言，索特罗维单抗治疗患者的住院风险也较低，但未达到统计学意义。
