TY - JOUR
AU - Tibble, Holly
AU - Proud, Euan
AU - Mueller, Tanja
AU - Hall, Elliott
AU - Kurdi, Amanj
AU - Robertson, Chris
AU - Bennie, Marion
AU - Woolford, Lana
AU - Laidlaw, Lynn
AU - Sterniczuk, Kamil
AU - Sheikh, Aziz
PY - 2024
DA - June
TI - Real-world severe COVID-19 outcomes associated with use of antivirals and neutralising monoclonal antibodies in Scotland
JO - npj Primary Care Respiratory Medicine 
VL - 34
DO - https://doi.org/10.1038/s41533-024-00374-x
AB - 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.
PB - Springer Nature
UR - https://strathprints.strath.ac.uk/89780/
KW - Coronavirus (COVID-19)
ER