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Results of the COCOPREV cohort

This is a prospective, multicentre, non-comparative national cohort which studied the efficacy of monoclonal antibodies in preventing severe manifestations of COVID-19 in a cohort of patients at high risk of progressing to a severe form of the disease.

The 4 articles published to date are summarised below:

1. Early administration of nirmatrelvir in high-risk patients, compared with sotrovimab, was associated with more rapid viral clearance. This may help to reduce transmission and prevent viral resistance. This analysis involved 255 patients included in the study (195 patients treated with sotrovimab and 60 treated with nirmatrevir/ritonavir).
2. Early administration of sotrovimab to Omicron-infected patients was associated with a low rate of COVID-19-related hospitalisations within one month of treatment, and no deaths. This analysis was performed in 249 patients included in the study (133 patients infected with the Delta variant of SARSCOV-2 and treated with casirivimab/imdevimab and 116 patients infected with the Omicron variant and treated with sotrovimab).
3. Administration of 500 mg of sotrovimab induces seroneutralisation and cellular cytotoxicity dependent on antibodies to BQ.1.1 and XBB.1.5. Sotrovimab may therefore remain a therapeutic option against these variants. This analysis was carried out on 80 patients included in the study (67 treated with monoclonal antibodies, including 29 with sotrovimab, and 13 patients treated with nilmatrevir/ritonavir).
4. The likelihood of emerging mutations appearing in response to monoclonal antibodies is significant in treated patients, highlighting the crucial need to study these mutations in depth and assess their impact on patients and on the evolutionary trajectory of SARS-CoV-2. This analysis was performed on 264 patients included in the study and treated with casirivimab/imdevimab, sotrovimab, or tixagevimab/cilgavimab.