Korean J Transplant.  2023 Dec;37(4):277-285. 10.4285/kjt.23.0038.

Sotrovimab in solid organ transplant recipients with COVID-19: a systematic review and meta-analysis

• Amani B
• Shabestan R
• Rajabkhah K
• Amani B

• KMID: 2550239
• DOI: http://doi.org/10.4285/kjt.23.0038

Abstract

Background
Despite widespread implementation of vaccination against coronavirus disease 2019 (COVID-19), solid organ transplant recipients (SOTRs) can remain partic-ularly vulnerable to this disease. The present study was conducted to investigate the efficacy and safety of sotrovimab in the treatment of SOTRs with COVID-19.
Methods
A search was performed of PubMed, Cochrane Library, Web of Science, medRxiv, and Google Scholar to gather relevant evidence through July 25, 2023. The quality of the included studies was assessed using the risk of bias tool. Comprehensive Meta-Analysis software (ver. 3.0, Biostat) was employed for data analysis.
Results
Ten studies, involving a total of 1,569 patients, were included. The meta-analysis revealed significant differences between the patients administered sotrovimab and those treated with the standard of care. These differences were observed in mortality rate (odds ratio [OR], 0.15; 95% confidence interval [CI], 0.03–0.67), hospitalization rate (OR, 0.35; 95% CI, 0.21–0.57), intensive care unit (ICU) admission rate (OR, 0.16; 95% CI, 0.04–0.62), the need for supplemental oxygen therapy (OR, 0.22; 95% CI, 0.09–0.51), and the need for mechanical ventilation (OR, 0.09; 95% CI, 0.01–0.70). However, no signifi-cant difference was observed between sotrovimab and other treatments regarding the rates of hospitalization or ICU admission (P>0.05). Regarding safety, sotrovimab was associated with a lower rate of adverse events compared to the absence of sotrovimab (OR, 0.15; 95% CI, 0.02–0.86).
Conclusions
These results suggest that sotrovimab may improve efficacy outcomes among SOTRs with COVID-19. Nevertheless, additional high-quality trials are necessary to confirm these findings.

Keyword

COVID-19; SARS-CoV-2; Organ transplantation

Figure

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  Fig. 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart.

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  Fig. 2 Forest plot of sotrovimab versus standard of care for mortality rate. CI, confidence interval.

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  Fig. 3 Forest plot of sotrovimab versus standard of care for hospitalization rate. CI, confidence interval.

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  Fig. 4 Forest plot of sotrovimab versus standard of care for intensive care unit admission. CI, confidence interval.

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  Fig. 5 Forest plot of sotrovimab versus absence of sotrovimab for adverse events. CI, confidence interval.

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