Efficacy and Safety of Sotrovimab Versus Oral Antiviral for Early Treatment in High-Risk Patients in Omicron Era: A Multicenter Retrospective Study Article Swipe
Antonio Russo
,
Mariantonietta Pisaturo
,
Chiara Cacace
,
Augusta Troise
,
Guido Granata
,
Pierantonio Grimaldi
,
Enrico Allegorico
,
Francesca Ambrisi
,
Martina Papillo
,
Fabio Giuliano Numis
,
Nicola Coppola
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.3390/pathogens14030216
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.3390/pathogens14030216
Introduction: High-risk patients with COVID-19 benefit from early treatment to prevent severe outcomes. Sotrovimab, a monoclonal antibody, and oral antivirals such as nirmatrelvir/ritonavir and molnupiravir have been used for early intervention, but their comparative efficacy and safety, particularly during the Omicron-dominant phase, require further evaluation. Methods: A multicenter, retrospective study performed in southern Italy including all adult patients who received early antiviral treatment (sotrovimab or nirmatrelvir/r or molnupiravir) between January 2022 and February 2024 (omicron phase). Demographic, clinical, and treatment-related data were analyzed to assess primary endpoints of 28-day mortality and hospitalization. Logistic regression models identified predictors of key outcomes. Results: A total of 668 high-risk patients treated with sotrovimab (n = 326) or oral antivirals (n = 342: 69 with molnupiravir and 273 with nirmatrelvir/ritonavir) were included. There was no significant difference in 28-day mortality between groups (0.8% sotrovimab vs. 1.8% oral antivirals; p = 0.679). However, patients treated with sotrovimab exhibited a longer median time to SARS-CoV-2 negativization (13 vs. 11 days; p = 0.008) and higher non–COVID-19-related hospitalizations (2.45% vs. 0%; p = 0.003). Multivariable analysis identified cardiovascular or cerebrovascular diseases as the sole significant predictor of prolonged viral positivity (OR 1.585, 95% CI 1.072–2.345; p = 0.021). Additionally, immunocompromised status (OR 16.929, 95% CI 1.835–156.170; p = 0.013) and chronic non-COVID-19 oxygen therapy (OR 10.714, 95% CI 1.623–70.725; p = 0.014) were strongly associated with mortality. Conclusions: Sotrovimab and oral antivirals demonstrated similar efficacy in preventing mortality and hospitalization among high-risk patients. Patient-specific factors, particularly cardiovascular comorbidities and immunosuppression, significantly influenced outcomes and should guide treatment choices.
Related Topics
Concepts
Medicine
Internal medicine
Ritonavir
Retrospective cohort study
Logistic regression
Coronavirus disease 2019 (COVID-19)
Multicenter study
Viral load
Immunology
Virus
Randomized controlled trial
Disease
Antiretroviral therapy
Infectious disease (medical specialty)
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3390/pathogens14030216
- https://www.mdpi.com/2076-0817/14/3/216/pdf?version=1740204923
- OA Status
- gold
- References
- 23
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4407875940
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4407875940Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.3390/pathogens14030216Digital Object Identifier
- Title
-
Efficacy and Safety of Sotrovimab Versus Oral Antiviral for Early Treatment in High-Risk Patients in Omicron Era: A Multicenter Retrospective StudyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-02-22Full publication date if available
- Authors
-
Antonio Russo, Mariantonietta Pisaturo, Chiara Cacace, Augusta Troise, Guido Granata, Pierantonio Grimaldi, Enrico Allegorico, Francesca Ambrisi, Martina Papillo, Fabio Giuliano Numis, Nicola CoppolaList of authors in order
- Landing page
-
https://doi.org/10.3390/pathogens14030216Publisher landing page
- PDF URL
-
https://www.mdpi.com/2076-0817/14/3/216/pdf?version=1740204923Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://www.mdpi.com/2076-0817/14/3/216/pdf?version=1740204923Direct OA link when available
- Concepts
-
Medicine, Internal medicine, Ritonavir, Retrospective cohort study, Logistic regression, Coronavirus disease 2019 (COVID-19), Multicenter study, Viral load, Immunology, Virus, Randomized controlled trial, Disease, Antiretroviral therapy, Infectious disease (medical specialty)Top concepts (fields/topics) attached by OpenAlex
- Cited by
-
0Total citation count in OpenAlex
- References (count)
-
23Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.(OR | 193, 204, 217 |
| abstract_inverted_index.0%; | 173 |
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| abstract_inverted_index.668 | 104 |
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| abstract_inverted_index.1.8% | 141 |
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| abstract_inverted_index.were | 81, 126, 225 |
| abstract_inverted_index.with | 3, 108, 120, 124, 150, 228 |
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| abstract_inverted_index.their | 32 |
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| abstract_inverted_index.viral | 191 |
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| abstract_inverted_index.0.008) | 166 |
| abstract_inverted_index.0.013) | 211 |
| abstract_inverted_index.0.014) | 224 |
| abstract_inverted_index.1.585, | 194 |
| abstract_inverted_index.28-day | 88, 134 |
| abstract_inverted_index.assess | 84 |
| abstract_inverted_index.during | 38 |
| abstract_inverted_index.groups | 137 |
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| abstract_inverted_index.longer | 154 |
| abstract_inverted_index.median | 155 |
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| abstract_inverted_index.phase, | 41 |
| abstract_inverted_index.severe | 11 |
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| abstract_inverted_index.0.003). | 176 |
| abstract_inverted_index.0.021). | 200 |
| abstract_inverted_index.0.679). | 146 |
| abstract_inverted_index.10.714, | 218 |
| abstract_inverted_index.16.929, | 205 |
| abstract_inverted_index.January | 69 |
| abstract_inverted_index.benefit | 5 |
| abstract_inverted_index.between | 68, 136 |
| abstract_inverted_index.chronic | 213 |
| abstract_inverted_index.further | 43 |
| abstract_inverted_index.phase). | 75 |
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| abstract_inverted_index.primary | 85 |
| abstract_inverted_index.require | 42 |
| abstract_inverted_index.safety, | 36 |
| abstract_inverted_index.similar | 236 |
| abstract_inverted_index.therapy | 216 |
| abstract_inverted_index.treated | 107, 149 |
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| abstract_inverted_index.COVID-19 | 4 |
| abstract_inverted_index.February | 72 |
| abstract_inverted_index.However, | 147 |
| abstract_inverted_index.Logistic | 92 |
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| abstract_inverted_index.Results: | 100 |
| abstract_inverted_index.analysis | 178 |
| abstract_inverted_index.analyzed | 82 |
| abstract_inverted_index.choices. | 260 |
| abstract_inverted_index.diseases | 183 |
| abstract_inverted_index.efficacy | 34, 237 |
| abstract_inverted_index.factors, | 247 |
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| abstract_inverted_index.patients | 2, 57, 106, 148 |
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| abstract_inverted_index.outcomes. | 12, 99 |
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