Evidence map›Paper›PMID 40952651›Full record

ArticleInfectious diseases and therapy2025

Antiviral Combination Treatment for COVID-19 in Immunocompromised Patients: Towards Defining Its Place in Therapy.

Chiara Sepulcri, Claudia Bartalucci, Elisa Balletto, Chiara Dentone, Federica Magné, Michele Mirabella, Silvia Dettori, Martina Bavastro, Carmen Di Grazia, Anna Maria Raiola and 7 more

Abstract read
In one paragraph

Article in Infectious diseases and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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 · 2026
    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

17 authors.

Chiara SepulcriDivision of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.
Claudia BartalucciDivision of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.
Elisa BallettoIRCCS Ospedale Policlinico San Martino, Genova, Italy.
Chiara DentoneIRCCS Ospedale Policlinico San Martino, Genova, Italy.
Federica MagnéIRCCS Ospedale Policlinico San Martino, Genova, Italy.
Michele MirabellaIRCCS Ospedale Policlinico San Martino, Genova, Italy.
Silvia DettoriIRCCS Ospedale Policlinico San Martino, Genova, Italy.
Martina BavastroDivision of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.
Carmen Di GraziaEmatologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Anna Maria RaiolaEmatologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Massimiliano GambellaEmatologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Valentina RicucciHygiene Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Bianca BruzzoneHygiene Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Sabrina BeltraminiPharmacy Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Emanuele AngelucciEmatologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Matteo BassettiDivision of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genova, Italy.
Malgorzata MikulskaDivision of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genova, Italy. m.mikulska@unige.it.ORCID http://orcid.org/0000-0002-5535-4602

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAntiviral combinations have been successfully used to treat COVID-19 in immunocompromised patients, especially those with prolonged viral shedding or relapses. This study assessed outcomes of antiviral combination therapy, stratified by clinical indication.

methodsIn this retrospective single-center study (October 2022-March 2024), patients receiving antiviral combinations were stratified according to treatment indication: prolonged/relapsed infection (group 1), severe COVID-19 (group 2), or early treatment of non-severe COVID-19 (group 3). Outcomes included virological clearance at day 14, and success rate at days 30 and 100.

resultsSeventy-one patients were included (group 1: 43; group 2 and 3: 14 each); 52% had non-Hodgkin lymphoma, 39.4% prior anti-CD20 therapy, 32% transplant/CAR-T. Most (92.6%) were vaccinated (median three doses). Treatment consisted of two antivirals in 59 patients (82%), mainly 10 days of both remdesivir and nirmatrelvir/ritonavir (n = 52, 73%), two antivirals plus single-dose tixagevimab/cilgavimab in 11 (15%), and three antivirals in 1. Virological clearance by day 14 was achieved in 79% (52/66 evaluable patients): 85% (34/40) in group 1, 58% (7/12) in group 2, 78.6% (11/14) in group 3. In group 1, predictors of day 14 clearance were prior vaccination and combination treatment with ≥ 10 days of oral antiviral. Success rates at days 30 and 100 were 80% (57/71) and 79% (56/71), respectively, with no significant differences between groups. Five patients required further treatment courses. COVID-19-related mortality was 12.5% (9/71). Three grade 2 adverse events occurred.

conclusionsAntiviral combination therapy was effective in prolonged/relapsed and severe COVID-19 while its role in early mild infections warrants further study. Stratifying patients by treatment indication facilitates outcome interpretation and comparisons.

Indexed as

Anti-SARS-CoV-2 monoclonal antibodiesHematologic malignancyMolnupiravirNirmatrelvirRemdesivir

Identifiers

PMID40952651
PMCPMC12511465

What OpenQuestion holds

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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.