Evidence map›Paper›PMID 38942748›Full record

ArticleNPJ primary care respiratory medicine2024

Real-world severe COVID-19 outcomes associated with use of antivirals and neutralising monoclonal antibodies in Scotland.

Holly Tibble, Tanja Mueller, Euan Proud, Elliott Hall, Amanj Kurdi, Chris Robertson, Marion Bennie, Lana Woolford, Lynn Laidlaw, Kamil Sterniczuk and 1 more

Abstract read
In one paragraph

Article in NPJ primary care respiratory medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Holly TibbleUsher Institute, University of Edinburgh, Edinburgh, Scotland. Holly.Tibble@ed.ac.uk.ORCID 0000-0001-7169-4087
Tanja MuellerPublic Health Scotland, Glasgow, Scotland.ORCID 0000-0002-0418-4789
Euan ProudPublic Health Scotland, Glasgow, Scotland.
Elliott HallPublic Health Scotland, Glasgow, Scotland.
Amanj KurdiPublic Health Scotland, Glasgow, Scotland.
Chris RobertsonPublic Health Scotland, Glasgow, Scotland.ORCID 0000-0001-6848-5241
Marion BenniePublic Health Scotland, Glasgow, Scotland.
Lana WoolfordUsher Institute, University of Edinburgh, Edinburgh, Scotland.
Lynn LaidlawPatient Contributor, London, UK.
Kamil SterniczukPatient Contributor, London, UK.
Aziz SheikhUsher Institute, University of Edinburgh, Edinburgh, Scotland.

Funding

DH | National Institute for Health Research (NIHR) NIHR135575RCUK | Medical Research Council (MRC) UKRIMC_PC19075
6 · The paper itself

Abstract

We sought to investigate the incidence of severe COVID-19 outcomes after treatment with antivirals and neutralising monoclonal antibodies, and estimate the comparative effectiveness of treatments in community-based individuals. We conducted a retrospective cohort study investigating clinical outcomes of hospitalisation, intensive care unit admission and death, in those treated with antivirals and monoclonal antibodies for COVID-19 in Scotland between December 2021 and September 2022. We compared the effect of various treatments on the risk of severe COVID-19 outcomes, stratified by most prevalent sub-lineage at that time, and controlling for comorbidities and other patient characteristics. We identified 14,365 individuals treated for COVID-19 during our study period, some of whom were treated for multiple infections. The incidence of severe COVID-19 outcomes (inpatient admission or death) in community-treated patients (81% of all treatment episodes) was 1.2% (n = 137/11894, 95% CI 1.0-1.4), compared to 32.8% in those treated in hospital for acute COVID-19 (re-admissions or death; n = 40/122, 95% CI 25.1-41.5). For community-treated patients, there was a lower risk of severe outcomes (inpatient admission or death) in younger patients, and in those who had received three or more COVID-19 vaccinations. During the period in which BA.2 was the most prevalent sub-lineage in the UK, sotrovimab was associated with a reduced treatment effect compared to nirmaltrelvir + ritonavir. However, since BA.5 has been the most prevalent sub-lineage in the UK, both sotrovimab and nirmaltrelvir + ritonavir were associated with similarly lower incidence of severe outcomes than molnupiravir. Around 1% of those treated for COVID-19 with antivirals or neutralising monoclonal antibodies required hospital admission. During the period in which BA.5 was the prevalent sub-lineages in the UK, molnupiravir was associated with the highest incidence of severe outcomes in community-treated patients.

Indexed as

Antibodies, MonoclonalAntiviral AgentsCOVID-19COVID-19 Drug TreatmentHospitalizationSARS-CoV-2AdultAgedAntibodies, NeutralizingFemaleHumansIncidenceIntensive Care UnitsMaleMiddle AgedRetrospective StudiesAntibodies, MonoclonalAntibodies, NeutralizingAntiviral Agents

Identifiers

PMID38942748
PMCPMC11213868

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.