Real-World Effectiveness of Sotrovimab in Patients Infected With SARS-CoV-2 Omicron Subvariant BA.2 in Western Sydney, Australia

Eric Kalo; Ziad Basyouni; Gideon Meyerowitz Katz; Vahid Karkvandi; Leanne Watson; Helen Crowther; Scott Read; Matthew V N O'Sullivan; Jasmin Ellis; Joanne Medlin; Golo Ahlenstiel

doi:10.1002/jmv.70235

Real-World Effectiveness of Sotrovimab in Patients Infected With SARS-CoV-2 Omicron Subvariant BA.2 in Western Sydney, Australia

J Med Virol. 2025 Feb;97(2):e70235. doi: 10.1002/jmv.70235.

Authors

Eric Kalo¹, Ziad Basyouni², Gideon Meyerowitz Katz², Vahid Karkvandi², Leanne Watson^{2

3}, Helen Crowther¹, Scott Read^{1

3

4}, Matthew V N O'Sullivan^{5

6

7}, Jasmin Ellis², Joanne Medlin², Golo Ahlenstiel^{1

2

3

4}

Affiliations

¹ Blacktown Clinical School and Research Centre, School of Medicine, Western Sydney University, Blacktown, New South Wales, Australia.
² Integrated and Community Health, Western Sydney Local Health District, Blacktown Hospital, Blacktown, New South Wales, Australia.
³ Blacktown Hospital, Western Sydney Local Health District, Blacktown, New South Wales, Australia.
⁴ Storr Liver Centre, The Westmead Institute for Medical Research, Westmead, New South Wales, Australia.
⁵ Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, New South Wales, Australia.
⁶ New South Wales Health Pathology, ICPMR-Westmead, Westmead, New South Wales, Australia.
⁷ Sydney Infectious Diseases Institute, University of Sydney, Camperdown, Australia.

Abstract

Laboratory-based findings suggest that Sotrovimab is significantly less effective against emerging CARS-CoV-2 variants, however, clinical data is lacking. Here we examined the effectiveness of sotrovimab, in preventing emergency department (ED) presentation and subsequent hospitalization in high-risk subgroups of patients during the SARS-CoV-2 Delta and Omicron waves in Western Sydney, Australia (n = 515). Risk for ED attendance was comparable in Omicron patients, whether BA.1 or BA.2, compared to Delta patients (hazard ratio of 0.97 [0.36-2.64]). These findings highlight the need for caution when using in vitro findings to drive clinical practice, especially when the consequence is to withhold potentially lifesaving treatment.

Keywords: COVID‐19; Delta; Omicron BA.2; SARS‐CoV‐2; hospitalisation; monoclonal; sotrovimab.

MeSH terms

Adult
Aged
Antibodies, Monoclonal, Humanized* / therapeutic use
Antiviral Agents* / therapeutic use
Australia / epidemiology
COVID-19 Drug Treatment*
COVID-19* / epidemiology
COVID-19* / virology
Emergency Service, Hospital / statistics & numerical data
Female
Hospitalization / statistics & numerical data
Humans
Male
Middle Aged
SARS-CoV-2* / drug effects

Substances

Antibodies, Monoclonal, Humanized
Antiviral Agents

Supplementary concepts

SARS-CoV-2 variants

Grants and funding

The authors received no specific funding for this work.