Comparative Effectiveness of Antiviral Agents and Monoclonal Antibodies for Early SARS-CoV-2 Therapy in Immunocompromised Patients: A Multicenter Retrospective Cohort Study (March 2021–March 2022)
Immunocompromised (IC) patients continue to be at risk of severe COVID-19 despite vaccination and anti-SARS-CoV-2 therapies. The comparative effectiveness of antiviral agents (AVAs) and monoclonal antibodies (MoAbs) as early treatment of SARS-CoV-2 in IC patients is described in this work. This retr...
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2025-05-01
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| author | Serena Vita Gaetano Maffongelli Tommaso Ascoli Bartoli Domenico Benvenuto Raffaella Marocco Silvia Rosati Valentina Mazzotta Cosmo Del Borgo Ilaria Mastrorosa Patrizia De Marco Alessandra D’Abramo Fabrizio Maggi Andrea Antinori Miriam Lichtner Emanuele Nicastri COVID Group |
| author_facet | Serena Vita Gaetano Maffongelli Tommaso Ascoli Bartoli Domenico Benvenuto Raffaella Marocco Silvia Rosati Valentina Mazzotta Cosmo Del Borgo Ilaria Mastrorosa Patrizia De Marco Alessandra D’Abramo Fabrizio Maggi Andrea Antinori Miriam Lichtner Emanuele Nicastri COVID Group |
| author_sort | Serena Vita |
| collection | DOAJ |
| description | Immunocompromised (IC) patients continue to be at risk of severe COVID-19 despite vaccination and anti-SARS-CoV-2 therapies. The comparative effectiveness of antiviral agents (AVAs) and monoclonal antibodies (MoAbs) as early treatment of SARS-CoV-2 in IC patients is described in this work. This retrospective multicenter cohort study included IC outpatients diagnosed with SARS-CoV-2 between March 2021 and March 2022 at the National Institute for Infectious Diseases “Lazzaro Spallanzani” and Santa Maria Goretti University Hospital, Italy. Patients received either AVAs or MoAbs based on national guidelines. The primary outcome was time to negative nasopharyngeal swab (NPS). The secondary outcomes were COVID-19-related hospitalization or death by day 30. Among 1472 IC patients (with a median age of 58 years, 45% male), 688 (46%) were treated with MoAbs, and 783 (54%) were treated with AVAs. The patients treated with MoAbs had a higher duration to negative NPS (17 vs. 11 days, <i>p</i> < 0.05) and a higher risk of sustained SARS-CoV-2 positivity on day 7 (OR: 3.0, 95% CI: 1.72–5.23, <i>p</i> < 0.01) and day 30 (OR: 6.0, 95% CI: 3.7–10.5, <i>p</i> < 0.01) than those treated with AVAs. There were no differences in hospitalization or mortality. AVAs were associated with a more rapid viral clearance than MoAbs, suggesting a potential advantage for reducing infectious duration in IC patients. Additional studies are necessary to further optimize the early treatment of COVID-19 in this high-risk population. |
| format | Article |
| id | doaj-art-f43ce37a05cd43ac854a3f5c830942e2 |
| institution | DOAJ |
| issn | 2076-2607 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
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| series | Microorganisms |
| spelling | doaj-art-f43ce37a05cd43ac854a3f5c830942e22025-08-20T03:14:43ZengMDPI AGMicroorganisms2076-26072025-05-01135107610.3390/microorganisms13051076Comparative Effectiveness of Antiviral Agents and Monoclonal Antibodies for Early SARS-CoV-2 Therapy in Immunocompromised Patients: A Multicenter Retrospective Cohort Study (March 2021–March 2022)Serena Vita0Gaetano Maffongelli1Tommaso Ascoli Bartoli2Domenico Benvenuto3Raffaella Marocco4Silvia Rosati5Valentina Mazzotta6Cosmo Del Borgo7Ilaria Mastrorosa8Patrizia De Marco9Alessandra D’Abramo10Fabrizio Maggi11Andrea Antinori12Miriam Lichtner13Emanuele Nicastri14COVID Group15National Institute for Infectious Diseases Lazzaro Spallanzani—IRCCS, 00149 Rome, ItalyNational Institute for Infectious Diseases Lazzaro Spallanzani—IRCCS, 00149 Rome, ItalyNational Institute for Infectious Diseases Lazzaro Spallanzani—IRCCS, 00149 Rome, ItalyDipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyInfectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, ItalyNational Institute for Infectious Diseases Lazzaro Spallanzani—IRCCS, 00149 Rome, ItalyNational Institute for Infectious Diseases Lazzaro Spallanzani—IRCCS, 00149 Rome, ItalyInfectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, ItalyNational Institute for Infectious Diseases Lazzaro Spallanzani—IRCCS, 00149 Rome, ItalyNational Institute for Infectious Diseases Lazzaro Spallanzani—IRCCS, 00149 Rome, ItalyNational Institute for Infectious Diseases Lazzaro Spallanzani—IRCCS, 00149 Rome, ItalyNational Institute for Infectious Diseases Lazzaro Spallanzani—IRCCS, 00149 Rome, ItalyNational Institute for Infectious Diseases Lazzaro Spallanzani—IRCCS, 00149 Rome, ItalyInfectious Diseases Unit, Santa Maria (SM) Goretti Hospital, Sapienza University of Rome, 04100 Latina, ItalyNational Institute for Infectious Diseases Lazzaro Spallanzani—IRCCS, 00149 Rome, ItalyNational Institute for Infectious Diseases Lazzaro Spallanzani—IRCCS, 00149 Rome, ItalyImmunocompromised (IC) patients continue to be at risk of severe COVID-19 despite vaccination and anti-SARS-CoV-2 therapies. The comparative effectiveness of antiviral agents (AVAs) and monoclonal antibodies (MoAbs) as early treatment of SARS-CoV-2 in IC patients is described in this work. This retrospective multicenter cohort study included IC outpatients diagnosed with SARS-CoV-2 between March 2021 and March 2022 at the National Institute for Infectious Diseases “Lazzaro Spallanzani” and Santa Maria Goretti University Hospital, Italy. Patients received either AVAs or MoAbs based on national guidelines. The primary outcome was time to negative nasopharyngeal swab (NPS). The secondary outcomes were COVID-19-related hospitalization or death by day 30. Among 1472 IC patients (with a median age of 58 years, 45% male), 688 (46%) were treated with MoAbs, and 783 (54%) were treated with AVAs. The patients treated with MoAbs had a higher duration to negative NPS (17 vs. 11 days, <i>p</i> < 0.05) and a higher risk of sustained SARS-CoV-2 positivity on day 7 (OR: 3.0, 95% CI: 1.72–5.23, <i>p</i> < 0.01) and day 30 (OR: 6.0, 95% CI: 3.7–10.5, <i>p</i> < 0.01) than those treated with AVAs. There were no differences in hospitalization or mortality. AVAs were associated with a more rapid viral clearance than MoAbs, suggesting a potential advantage for reducing infectious duration in IC patients. Additional studies are necessary to further optimize the early treatment of COVID-19 in this high-risk population.https://www.mdpi.com/2076-2607/13/5/1076SARS-CoV-2COVID-19immunocompromised patientsantiviral agentsmonoclonal antibodies |
| spellingShingle | Serena Vita Gaetano Maffongelli Tommaso Ascoli Bartoli Domenico Benvenuto Raffaella Marocco Silvia Rosati Valentina Mazzotta Cosmo Del Borgo Ilaria Mastrorosa Patrizia De Marco Alessandra D’Abramo Fabrizio Maggi Andrea Antinori Miriam Lichtner Emanuele Nicastri COVID Group Comparative Effectiveness of Antiviral Agents and Monoclonal Antibodies for Early SARS-CoV-2 Therapy in Immunocompromised Patients: A Multicenter Retrospective Cohort Study (March 2021–March 2022) Microorganisms SARS-CoV-2 COVID-19 immunocompromised patients antiviral agents monoclonal antibodies |
| title | Comparative Effectiveness of Antiviral Agents and Monoclonal Antibodies for Early SARS-CoV-2 Therapy in Immunocompromised Patients: A Multicenter Retrospective Cohort Study (March 2021–March 2022) |
| title_full | Comparative Effectiveness of Antiviral Agents and Monoclonal Antibodies for Early SARS-CoV-2 Therapy in Immunocompromised Patients: A Multicenter Retrospective Cohort Study (March 2021–March 2022) |
| title_fullStr | Comparative Effectiveness of Antiviral Agents and Monoclonal Antibodies for Early SARS-CoV-2 Therapy in Immunocompromised Patients: A Multicenter Retrospective Cohort Study (March 2021–March 2022) |
| title_full_unstemmed | Comparative Effectiveness of Antiviral Agents and Monoclonal Antibodies for Early SARS-CoV-2 Therapy in Immunocompromised Patients: A Multicenter Retrospective Cohort Study (March 2021–March 2022) |
| title_short | Comparative Effectiveness of Antiviral Agents and Monoclonal Antibodies for Early SARS-CoV-2 Therapy in Immunocompromised Patients: A Multicenter Retrospective Cohort Study (March 2021–March 2022) |
| title_sort | comparative effectiveness of antiviral agents and monoclonal antibodies for early sars cov 2 therapy in immunocompromised patients a multicenter retrospective cohort study march 2021 march 2022 |
| topic | SARS-CoV-2 COVID-19 immunocompromised patients antiviral agents monoclonal antibodies |
| url | https://www.mdpi.com/2076-2607/13/5/1076 |
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