Impact of treatment of COVID-19 with sotrovimab on post-acute sequelae of COVID-19 (PASC): an analysis of National COVID Cohort Collaborative (N3C) data.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-03-22 DOI:10.1007/s15010-025-02505-z

Myriam Drysdale, Rose Chang, Tracy Guo, Mei Sheng Duh, Jennifer Han, Helen Birch, Catherine Sharpe, Daisy Liu, Sarah Kalia, Melissa Van Dyke, Maral DerSarkissian, Iain A Gillespie

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引用次数: 0

Abstract

Purpose: To assess the impact of early sotrovimab treatment versus no treatment on the risk of developing post-acute sequelae of COVID-19 (PASC; long COVID) in patients (age ≥ 12 years) with COVID-19 at high risk for progression to severe disease.

Methods: Retrospective cohort study using the US National COVID Cohort Collaborative (N3C) data. Phase 1 identified and assessed multiple definitions of PASC; Phase 2 evaluated the effectiveness of sotrovimab for reducing the risk of PASC, utilizing definitions from Phase 1. Average treatment effect in the treated (ATT)-weighted Cox proportional hazards regression models were used to compare time to event for PASC between high-risk patients who received sotrovimab treatment between May 26, 2021 and April 5, 2022, and high-risk patients with COVID-19 diagnosed between May 26, 2021 and March 26, 2022 who did not receive any treatment for COVID-19 during the acute phase or any pre-exposure prophylaxis against SARS-CoV-2.

Results: A total of 9,504 sotrovimab-treated and 619,668 untreated patients were included in the main analysis. Most baseline characteristics were balanced between the two cohorts after ATT weighting. The doubly robust ATT-weighted hazard ratio (95% confidence interval) was 0.92 (0.89-0.96) (p < 0.001), indicating that sotrovimab use was associated with a significantly lower risk of PASC. Results remained consistent in sensitivity analyses.

Conclusion: In patients at high risk for severe COVID-19, the benefits of early sotrovimab treatment may extend beyond the acute phase of COVID-19 and contribute to the prevention of PASC symptoms.

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sotrovimab治疗COVID-19对COVID-19急性后后遗症（PASC）的影响：国家COVID队列协作（N3C）数据分析

目的：评估早期sotrovimab治疗与未治疗对COVID-19急性后后遗症（PASC）发生风险的影响；患有COVID-19的患者（年龄≥12岁）进展为严重疾病的高风险。方法：采用美国国家COVID队列协作（N3C）数据进行回顾性队列研究。第一阶段确定并评估了PASC的多种定义；第二阶段评估了sotrovimab降低PASC风险的有效性，使用了第一阶段的定义。采用治疗组的平均治疗效果（ATT）加权Cox比例风险回归模型，比较2021年5月26日至2022年4月5日期间接受索罗维单抗治疗的高危患者与2021年5月26日至2022年3月26日期间诊断为COVID-19的高危患者在急性期未接受任何COVID-19治疗或未接受任何针对SARS-CoV-2的暴露前预防的PASC的时间与事件。结果：共有9504例sotrovimab治疗患者和619668例未治疗患者纳入主分析。在ATT加权后，大多数基线特征在两个队列之间得到平衡。双稳健的at加权风险比（95%可信区间）为0.92 (0.89-0.96)(p)。结论：在严重COVID-19高危患者中，早期sotrovimab治疗的益处可能延伸到COVID-19急性期之外，并有助于预防PASC症状。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.