Clinical outcomes in sotrovimab-treated patients for SARS-CoV-2 infection in the United Arab Emirates and the Kingdom of Bahrain: a retrospective study

UAE and Bahrain authorized the emergency use of sotrovimab for mild-to-moderate coronavirus disease 2019 (COVID19). This observational study aimed to evaluate the clinical outcomes of sotrovimab in real-life setting in both countries. A bi-directional observational chart review study was conducted in both countries from June 2021 to March 2022 during Delta and Omicron SARS-CoV-2 variant surges. High-risk hospitalized patients with mild-to-moderate COVID-19 treated with sotrovimab and a matched (on age, gender, comorbidities, BMI, and vaccination status) controls were enrolled. The co-primary endpoints were proportion of patients with all-cause progression (requiring oxygen supplementation, admission to ICU/general ward, all-cause death) from date of sotrovimab administration (or the matched date for controls) through Day (D) 29, and proportion of patients with selected combinations of risk factors who progressed to severe COVID19 through D29. 15,771 patients from UAE and 1,482 patients from Bahrain received sotrovimab; 491 control patients were in Bahrain only. 33.2% of UAE patients and 25% of Bahrain patients were ≥60 years. Median number of risk factors per patient was 2. Dominant variant was Delta in the UAE (69%) and Bahrain (84.6%). The proportion of all-cause progression through D29 after sotrovimab administration was 12.8% (95%CI: 12.2%-13.3%) in the UAE. In Bahrain, the proportion of all-cause progression was 2.6% (95%CI: 1.8%-3.5%) significantly lower compared to control patients (15.5%; p<0.001). The combination of diabetes and heart disease increased the risk of allcause progression in treated and untreated patients. Sotrovimab demonstrated clinical benefit for preventing progression in patients with mild-moderate COVID-19.