Lack of efficacy for sotrovimab use in patients with COVID-19: A meta-analysis

Lessons we learned during the past four challenging years in the COVID-19 era: pharmacotherapy, long COVID complications, and vaccine development

About four years have passed since the detection of the first cases of COVID-19 in China. During this lethal pandemic, millions of people have lost their lives around the world. Since the first waves of COVID-19 infection, various pharmacotherapeutic agents have been examined in the management of COVID-19. Despite all these efforts in pharmacotherapy, drug repurposing, and design and development of new drugs, multiple organ involvement and various complications occurred during COVID-19. Some of these complications became chronic and long-lasting which led to the "long COVID" syndrome appearance. Therefore, the best way to eradicate this pandemic is prophylaxis through mass vaccination. In this regard, various vaccine platforms including inactivated vaccines, nucleic acid-based vaccines (mRNA and DNA vaccines), adenovirus-vectored vaccines, and protein-based subunit vaccines have been designed and developed to prevent or reduce COVID-19 infection, hospitalization, and mortality rates. In this focused review, at first, the most commonly reported clinical presentations of COVID-19 during these four years have been summarized. In addition, different therapeutic regimens and their latest status in COVID-19 management have been listed. Furthermore, the "long COVID" and related signs, symptoms, and complications have been mentioned. At the end, the effectiveness of available COVID-19 vaccines with different platforms against early SARS-CoV-2 variants and currently circulating variants of interest (VOI) and the necessity of booster vaccine shots have been summarized and discussed in more detail.

Efficacy and safety of sotrovimab in patients with COVID-19: A rapid review and meta-analysis

The therapeutic potential of sotrovimab in the treatment of coronavirus disease 2019 (COVID-19) is a controversial issue. The aim of this study was to evaluate the efficacy and safety of sotrovimab in COVID-19 patients. To this end, PubMed, Cochrane Library, Embase, Web of Science, medRxiv, and Google Scholar were searched up to 15 August 2022. The reference lists of key studies were also scanned to find additional records. Meta-analysis was performed using Comprehensive Meta-Analysis. Seventeen studies involving 27,429 patients were included. A significant difference was observed in mortality rate (odds ratio [OR] = 0.40; 95% CI: 0.25-0.63, p = 0.00), hospitalisation rate (OR = 0.53; 95% CI: 0.43-0.65. p = 0.00), hospital or death rate (OR = 0.43; 95% CI: 0.25-0.73, p = 0.00), the need for mechanical ventilation (OR = 0.57; 95% CI: 0.33-0.96, p = 0.03), and ICU admission (OR = 0.33; 95% CI: 0.17-0.67, p = 0.00) of the sotrovimab-receiving group compared to those having no sotrovimab. However, no significant difference was observed between the two groups in terms of disease progression (OR = 0.45; 95% CI: 0.16-1.24, p = 0.12) and emergency department visit (OR = 1.01; 95% CI: 0.83-1.24, p = 0.87). The two groups had no significant difference in terms of incidence of adverse events (OR = 0.98; 95% CI: 0.78-1.23, p = 0.88). The findings of the present meta-analysis support that sotrovimab could be an effective and safe treatment option to reduce mortality and hospitalisation rate in both Delta and Omicron Variants of COVID-19.