{Reference Type}: Journal Article
{Title}: 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.
{Author}: Bavaro DF;Diella L;Belati A;Metrangolo G;De Santis L;Spada V;Camporeale M;Dargenio A;Brindicci G;Balena F;Fiordelisi D;Signorile F;Loseto G;Pasciolla C;Minoia C;Attolico I;Perrone T;Simone S;Rendina M;Giovine N;Di Gennaro F;Musto P;Guarini A;Di Leo A;Gesualdo L;Dell'Aera M;Saracino A;
{Journal}: Viruses
{Volume}: 15
{Issue}: 5
{Year}: 2023 05 19
{Factor}: 5.818
{DOI}: 10.3390/v15051199
{Abstract}: 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.
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.
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.
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.