Early initiation of combined therapy in severely immunocompromised patients with COVID-19: a retrospective cohort study

BMC Infect Dis. 2024 Jun 6;24(1):564. doi: 10.1186/s12879-024-09466-y.

Abstract

This single-centre retrospective cohort study reports on the results of a descriptive (non-comparative) retrospective cohort study of early initiation of antivirals and combined monoclonal antibody therapy (mAbs) in 48 severely immunocompromised patients with COVID-19. The study assessed the outcomes and the duration of viral shedding. The patients started early combined therapy (ECT) a median of 2 days (interquartile range [IQR]: 1-3 days) after the diagnosis of SARS-CoV-2 infection. Except for 1 patient who died due COVID-19-related respiratory failure, patients had their first negative nasopharyngeal swab result after a median of 11 days (IQR: 6-17 days) after starting combined therapy. There were no reports of severe side effects. During a follow-up period of 512 days (interquartile range [IQR]: 413-575 days), 6 patients (12.5%) died and 16 (33.3%) were admitted to hospital. Moreover, 12 patients (25%) were diagnosed with SARS-CoV-2 reinfection a median of 245 days (IQR: 138-401 days) after starting combined treatment. No relapses were reported. Although there was no comparison group, these results compare favourably with the outcomes of severely immunocompromised patients with COVID-19 reported in the literature.

Keywords: Antivirals; COVID-19; Combined therapy; Immunocompromised; Monoclonal antibodies; SARS-CoV-2.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / therapeutic use
  • Antiviral Agents* / administration & dosage
  • Antiviral Agents* / therapeutic use
  • COVID-19 Drug Treatment*
  • COVID-19* / immunology
  • COVID-19* / mortality
  • Drug Therapy, Combination
  • Female
  • Humans
  • Immunocompromised Host*
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2* / immunology
  • Treatment Outcome
  • Virus Shedding / drug effects

Substances

  • Antiviral Agents
  • Antibodies, Monoclonal