ArticleVirology journal2023
Optimizing COVID-19 treatment in immunocompromised patients: early combination therapy with remdesivir, nirmatrelvir/ritonavir and sotrovimab.
Article in Virology journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Efficacy and safety of antiviral therapies for the treatment of persistent COVID-19 in immunocompromised patients since the Omicron surge: a systematic review.The Journal of antimicrobial chemotherapy · 2025Pooled it
- Is early combination therapy associated with lower risk of respiratory failure in severely immunocompromised hosts with COVID-19? a target trial emulation study from the omicron-dominant era.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Observational
- COVID-19 in immunocompromised patients: proposed definition of a new entity with prolonged infection.New microbes and new infections · 2025Article
- Early combined therapy for COVID-19 in immunocompromised patients: a promising approach against viral persistence and drug resistance.BMC infectious diseases · 2025Review
- Risk of Severe COVID-19 in Four Immunocompromised Populations: A French Expert Perspective.Infectious diseases and therapy · 2025Review
- Implication of Admission Eosinophil Count and Prognosis of Coronavirus Disease 2019 (COVID-19) in Elderly Patients With COPD: A Territory-Wide Cohort Study.The clinical respiratory journal · 2025Article
- Effectiveness of early intervention and combination treatment with monoclonal antibodies and antivirals in oncohematological patients with SARS-CoV-2: a retrospective experience.Frontiers in immunology · 2025Article
- Article
- Does early combination vs. Monotherapy improve clinical outcomes of clinically extremely vulnerable patients with COVID-19? Results from a retrospective propensity-weighted analysis.European journal of medical research · 2024Article
- Early initiation of combined therapy in severely immunocompromised patients with COVID-19: a retrospective cohort study.BMC infectious diseases · 2024Article
- Post COVID-19 Reflections and Questions: How Prepared Are We for the Next Pandemic?International journal of molecular sciences · 2024Article
- Real-Life Comparison of Antivirals for SARS-CoV-2 Omicron Infection in Patients With Hematologic Malignancies.Influenza and other respiratory viruses · 2024Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundMorbidity and mortality are higher in immunocompromised patients affected by COVID-19 than in the general population. Some authors have successfully used antiviral combination, but never in the early phase of the infection.
methodsWe conducted a retrospective cohort study to determine the efficacy and safety of the combination of two antivirals, with and without a monoclonal antibody (mAb), in both the early (within 10 days of symptoms) and in a later phase (after 10 days) of SARS-CoV-2 infection in immunocompromised patients admitted to our Facility.
resultsWe treated 11 patients (seven in an early phase and four in a late phase of COVID-19) with 10 days of intravenous remdesivir plus five days of oral nirmatelvir/ritonavir, also combined with sotrovimab in 10/11 cases. Notably, all the "early" patients reached virological clearance at day 30 from the end of the therapy and were alive and well at follow-up, whereas the corresponding numbers in the "late" patients were 50% and 75%. Patients in the "late" group more frequently needed oxygen supplementation (p = 0.015) and steroid therapy (p = 0.045) during admission and reached higher COVID-19 severity (p = 0.017). DISCUSSION: The combination of antiviral and sotrovimab in the early phase of COVID-19 is well tolerated by immunocompromised patients and is associated with 100% of virological clearance. Patients treated later have lower response rates and higher disease severity, but whether therapy plays a causative role in such findings has yet to be determined.
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