%0 Journal Article
%T Efficacy of Remdesivir and Neutralizing Monoclonal Antibodies in Monotherapy or Combination Therapy in Reducing the Risk of Disease Progression in Elderly or Immunocompromised Hosts Hospitalized for COVID-19: A Single Center Retrospective Study.
%A Bavaro DF
%A Diella L
%A Belati A
%A Metrangolo G
%A De Santis L
%A Spada V
%A Camporeale M
%A Dargenio A
%A Brindicci G
%A Balena F
%A Fiordelisi D
%A Signorile F
%A Loseto G
%A Pasciolla C
%A Minoia C
%A Attolico I
%A Perrone T
%A Simone S
%A Rendina M
%A Giovine N
%A Di Gennaro F
%A Musto P
%A Guarini A
%A Di Leo A
%A Gesualdo L
%A Dell'Aera M
%A Saracino A
%J Viruses
%V 15
%N 5
%D 2023 05 19
%M 37243285
%F 5.818
%R 10.3390/v15051199
%X Remdesivir (REM) and monoclonal antibodies (mAbs) could alleviate severe COVID-19 in at-risk outpatients. However, data on their use in hospitalized patients, particularly in elderly or immunocompromised hosts, are lacking.<BR>All consecutive patients hospitalized with COVID-19 at our unit from 1 July 2021 to 15 March 2022 were retrospectively enrolled. The primary outcome was the progression to severe COVID-19 (P/F < 200). Descriptive statistics, a Cox univariate-multivariate model, and an inverse probability treatment-weighted (IPTW) analysis were performed.<BR>Overall, 331 subjects were included; their median (q1-q3) age was 71 (51-80) years, and they were males in 52% of the cases. Of them, 78 (23%) developed severe COVID-19. All-cause in-hospital mortality was 14%; it was higher in those with disease progression (36% vs. 7%, p < 0.001). REM and mAbs resulted in a 7% (95%CI = 3-11%) and 14% (95%CI = 3-25%) reduction in the risk of severe COVID-19, respectively, after adjusting the analysis with the IPTW. In addition, by evaluating only immunocompromised hosts, the combination of REM and mAbs was associated with a significantly lower incidence of severe COVID-19 (aHR = 0.06, 95%CI = 0.02-0.77) when compared with monotherapy.<BR>REM and mAbs may reduce the risk of COVID-19 progression in hospitalized patients. Importantly, in immunocompromised hosts, the combination of mAbs and REM may be beneficial.