COCOPREV cohort

Prevention of complications of COVID-19 in high-risk subjects infected with SARS-CoV-2 and receiving curative treatment.

Last updated on 29 January 2025

The essential

The ANRS 0003S COCOPREV study is a national cohort which aims to study the response to curative treatments developed to reduce COVID-19-related complications in infected patients at risk during the pandemic period.

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.

Principal investigator
Dr Youri Yordanov et Pr Guillaume Martin-Blondel

Teams
Hôpital Saint Antoine Emergency Department, Toulouse University Hospital Infectious and Tropical Diseases Department, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), INSERM UMR-S 1136/ Sorbonne Universités, Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Pitié Salpêtrière Hospital Virology Laboratory, Virus and Immunity Unit, Institut Pasteur, CNRS UMR 3569 / Université Paris Cité

Start date/End date of study
21/09/2021 – 18/12/2023

Number of participants
756

Pathology
COVID-19

Sponsorship
Inserm-ANRS MIE

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Main publications

  1. Martin-Blondel G, Marcelin AG, Soulié C, .et al. Time to negative PCR conversion amongst high-risk patientswith mild-to-moderate Omicron BA.1 and BA.2 COVID-19 treated with sotrovimab ornirmatrelvir. Clin Microbiol Infect. 2023 Apr;29(4):543.e5-543.e9. doi:10.1016/j.cmi.2022.12.016. Epub 2022 Dec 28. PMID: 36586513; PMCID: PMC9794519.
  2.  Martin-Blondel G, Marcelin AG, Soulié C, et al. Outcome of very high-risk patientstreated by Sotrovimab for mild-to-moderate COVID-19 Omicron, a prospectivecohort study (the ANRS 0003S COCOPREV study). J Infect. 2022Jun;84(6):e101-e104. doi: 10.1016/j.jinf.2022.04.010. Epub 2022 Apr 7. PMID:35398409; PMCID: PMC8988484.
  3.  Bruel T, Vrignaud LL, Porrot F, et al. Sotrovimab therapy elicits antiviral activities against Omicron BQ.1.1and XBB.1.5 in sera of immunocompromised patients. Med. 2023 Oct13;4(10):664-667. doi: 10.1016/j.medj.2023.07.007. PMID: 37837962.
  4.  Leducq V, Zafilaza K, Fauchois A, et al. Spike protein genetic evolution in patients at high-risk of severe COVID-19 treated by monoclonal antibodies. J Infect Dis. 2023 Nov23:jiad523. doi: 10.1093/infdis/jiad523. Epub ahead of print. PMID: 37996072