Experience with sotrovimab treatment of SARS‐CoV‐2‐infected patients in Denmark

Aims To evaluate the experience with use of sotrovimab following severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) infection in high‐risk groups. Methods In a nationwide, population‐based cohort study, we identified all individuals treated with sotrovimab ( N = 2933) and stratified them by 4 high‐risk groups: (A) malignant haematological disease, (B) solid organ transplantation, (C) anti‐CD20 therapy ≤1 year and (D) other risks. Cox regression analysis was used to calculate hazard ratios for hospitalization, death and associated prognostic factors. Results Of 2933 sotrovimab‐treated individuals, 83% belonged to high‐risk groups (37.6% haematological malignancy, 27.4% solid organ transplantation and 17.5% treatment with anti‐CD20 ≤1 year). Only 17.8% had other risks (11.8% were pregnant, 10.7% primary immunodeficiency, 21.2% other malignancy, 4.3% received anti‐CD20 >1 year and 52.0% other/unknown causes). Within 90 days of infusion, 30.2% were hospitalized and 5.3% died. The main prognostic factors were the predefined high‐risk groups, mainly malignant haematological disease and age ≥65 years. Number of COVID‐19 vaccines (≥3) was associated with a decreased risk of hospitalization. The Delta but not the Omicron BA.2 variant was associated with a higher risk of death compared to the BA.1 variant. Conclusion More than 90% of the patients treated with sotrovimab belonged to the very high‐risk groups as described in the Danish guidelines. Sotrovimab‐treated individuals remained at a high risk of hospitalization and death which was strongly associated with the underlying immunocompromised state and age. Having received >3 COVID‐19 vaccines was association with decreased risk of death and hospitalization.