Methodology: 4/5
Usefulness: 4/5

Gupta A, et al. N Engl J Med. 2021 Nov 18;385(21):1941-1950.

Question and Methods: COMET-ICE trial evaluated the efficacy and safety of sotrovimab in high-risk, mild-to-moderate Covid-19 not requiring oxygen, within 5 days of symptom onset.
Findings: There was an 85% relative risk reduction (97.24% confidence interval [CI], 44 to 96; P = 0.002) for disease progression leading to hospitalization (for >24 hours) for any cause or death when sotrovimab was used. 
Limitations: This was a prespecified interim analysis. The presence of autologous immunity has not yet been analyzed to determine how this may affect the safety and efficacy of sotrovimab as well as its efficacy against emerging variants.

Interpretation: Sotrovimab can be an effective treatment for high-risk mild-moderate Covid-19 and prevents hospitalization and death in patients with no increased risk of serious adverse events.

By: Dr. Joyes Botros

Supervision: Dr. Jeff Perry




  • Joyes Botros

    Dr. Joyes Botros CCFP-EM

    View all posts
  • Jeff Perry

    Dr. Perry is an Emergency Physician and full Professor in the department of Epidemiology and Community Medicine. He has a special research interest in subarachnoid hemorrhage, TIA and stroke.

    View all posts
  • Hans Rosenberg

    Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.

    View all posts