Figure 1. Titers of anti-SARS-CoV-2 S antibody were compared by therapy according to vaccination status and COVID-19 subvariant prevalence. ((A): unvaccinated-delta, (B): vaccinated-delta, (C): vaccinated-BA.1, and (D): vaccinated-BA.5). Levels of anti-SARS-CoV-2 N antibody (cut off index, COI) were compared by therapy according to vaccination status and COVID-19 subvariant prevalence. ((E): unvaccinated-delta, (F): vaccinated-delta, (G): vaccinated-BA.1, and (H): vaccinated-BA.5). Titers of anti-SARS-CoV-2 S antibody were compared between day 0 and day 3 according to last vaccination (<3 mo, within 3 months; 3–6 mo, between 3 and 6 months; 6 mo<, over 6 months) during the BA.5 wave. (I) Levels of anti-SARS-CoV-2 N antibody were compared between day 0 and day 3 according to last vaccination (<3 mo, within 3 months; 3–6 mo, between 3 and 6 months; 6 mo<, over 6 months) during the BA.5 wave. (J) p-Values were calculated using two-way ANOVA with Sidak’s multiple comparison test (A–H) and the Wilcoxon rank sum test and collected for multiple comparisons using a false discovery rate step down procedure (I,J).

Figure 1. Titers of anti-SARS-CoV-2 S antibody were compared by therapy according to vaccination status and COVID-19 subvariant prevalence. ((A): unvaccinated-delta, (B): vaccinated-delta, (C): vaccinated-BA.1, and (D): vaccinated-BA.5). Levels of anti-SARS-CoV-2 N antibody (cut off index, COI) were compared by therapy according to vaccination status and COVID-19 subvariant prevalence. ((E): unvaccinated-delta, (F): vaccinated-delta, (G): vaccinated-BA.1, and (H): vaccinated-BA.5). Titers of anti-SARS-CoV-2 S antibody were compared between day 0 and day 3 according to last vaccination (<3 mo, within 3 months; 3–6 mo, between 3 and 6 months; 6 mo<, over 6 months) during the BA.5 wave. (I) Levels of anti-SARS-CoV-2 N antibody were compared between day 0 and day 3 according to last vaccination (<3 mo, within 3 months; 3–6 mo, between 3 and 6 months; 6 mo<, over 6 months) during the BA.5 wave. (J) p-Values were calculated using two-way ANOVA with Sidak’s multiple comparison test (A–H) and the Wilcoxon rank sum test and collected for multiple comparisons using a false discovery rate step down procedure (I,J).

Table 1. Patient characteristics during the delta wave.

Table 1. Patient characteristics during the delta wave.

VaccinatedUnvaccinatedCharacteristicCasirivimab/Imdevimab,
N = 13Triple Therapy,
N = 4p-ValueCasirivimab/Imdevimab, N = 10Triple Therapy,
N = 26p-ValueAge, mean ± SD65.5 ± 20.553.2 ± 3.30.250.8 ± 13.551.8 ± 11.9>0.9Sex (Female/Male)5/81/3>0.92/812/140.3Smoking History (Yes/No/Unknown)6/7/03/1/00.66/4/014/12/0>0.9Previous history of diabetes, N (%)4 (31%)2 (50%)0.60 (0%)4 (15%)0.6Previous history of ischemic heart disease, N (%)1 (7.7%)0 (0%)>0.91 (10%)0 (0%)0.3Lymphocyte count, /µL1260.9 ± 402.5802.2 ± 279.50.045917.7 ± 449.01013.2 ± 402.70.3WBC, /µL5490.0 ± 1703.06507.5 ± 695.80.24394.0 ± 1949.05253.8 ± 1672.30.3CRP, mg/dL3.3 ± 4.410.2 ± 4.80.0362.0 ± 2.08.0 ± 4.6<0.001D-dimer, mg/dL1.4 ± 0.92.1 ± 1.10.0660.9 ± 0.41.4 ± 0.3<0.001Oxygen therapy at hospitalization, L/min0.1 ± 0.33.0 ± 1.4<0.0010.2 ± 0.61.8 ± 1.2<0.001Chest X-ray abnormalities (>50%/<50%/0%)0/10/32/2/00.050/5/56/19/10.004Duration from onset to treatment2.7 ± 1.26.5 ± 4.00.122.9 ± 2.07.0 ± 2.2<0.001

Table 2. Patient characteristics during the BA.1 wave.

Table 2. Patient characteristics during the BA.1 wave.

VaccinatedCharacteristicSotrovimab, N = 14Triple Therapy, N = 10p-ValueAge, mean ± SD72.1 ± 21.677.5 ± 13.00.7Sex (Female/Male)6/83/70.7Smoking History (Yes/No/Unknown)7/5/26/4/00.7Previous history of diabetes, N (%)2 (14%)2 (20%)>0.9Previous history of ischemic heart disease, N (%)1 (7.1%)2 (20%)0.6Lymphocyte count, /µL1177.6 ± 391.81021.5 ± 488.20.3WBC, /µL5442.1 ± 2412.65732.0 ± 1704.70.3CRP, mg/dL2.6 ± 3.45.8 ± 5.70.079D-dimer, mg/dL1.1 ± 0.51.6 ± 1.00.13Oxygen therapy at hospitalization, L/min0.0 ± 0.02.0 ± 1.6<0.001Chest X-ray abnormalities (>50%/<50%/0%)0/6/81/9/00.006Duration from onset to treatment2.1 ± 0.83.8 ± 3.30.4

Table 3. Patient characteristics during the BA.5 wave.

Table 3. Patient characteristics during the BA.5 wave.

Vaccinated CharacteristicSotrovimab, N = 40Triple Therapy, N = 15Double Therapy, N = 11p-ValueAge, Mean ± SD79.2 ± 9.984.5 ± 9.782.5 ± 15.20.15Sex (Female/Male)22/1811/47/40.5Smoking History (Yes/No/Unknown)15/25/05/10/06/5/00.5Previous history of diabetes, N (%)10 (25%)3 (20%)1 (9.1%)0.6Previous history of ischemic heart disease, N (%)12 (30%)5 (33%)5 (45%)0.7Lymphocyte count, /µL1008.5 ± 470.3692.2 ± 332.9852.8 ± 591.70.036WBC, /µL6465.5 ± 3549.25998.0 ± 1726.87188.2 ± 3230.60.7CRP, mg/dL4.3 ± 6.04.2 ± 3.94.4 ± 3.60.6D-dimer, mg/dL3.9 ± 15.82.2 ± 1.93.6 ± 3.00.017Oxygen therapy at hospitalization, L/min0.2 ± 0.62.3 ± 1.32.8 ± 1.5<0.001Chest X-ray abnormalities (>50%/<50%/0%)2/13/253/10/23/8/0<0.001Duration from onset to treatment1.5 ± 1.02.0 ± 2.21.6 ± 1.3>0.9

Table 4. Titers of anti-SARS-CoV-2 S and N antibody according to treatment and vaccination status.

Table 4. Titers of anti-SARS-CoV-2 S and N antibody according to treatment and vaccination status.

S Antibody (U/mL)N Antibody (Cut off Index) Day 0Day 3Day 0Day 3 MedianQ1Q3MedianQ1Q3MedianQ1Q3MedianQ1Q3Unvaccinated-delta Casirivimab/imdevimab (N = 13)0.40.40.4154.0136.8173.80.060.060.120.080.066.86Triple therapy (N = 4)0.40.41.47.80.731.00.230.0610.445.240.3573.78Vaccinated-delta Casirivimab/imdevimab (N = 10)301.010.7689.015,295.011,649.021,268.50.060.065.910.070.0649.06Triple therapy (N = 26)176.549.01129.8264.0113.71972.30.810.0623.804.990.0639.80Vaccinated-BA.1 Sotrovimab (N = 14)223.5122.0409.517,042.511,529.322,518.00.060.060.080.070.060.34Triple therapy (N = 10)1220.0141.57967.07347.5384.020,528.00.060.060.160.090.061.42Vaccinated-BA.5 Sotrovimab (N = 40)2154.0864.06669.321,371.019,656.332,225.00.070.070.110.070.070.13Triple therapy (N = 15)3767.0500.06754.05083.02278.016,847.00.070.060.140.070.072.43Double therapy (N = 11)1864.0303.05001.02190.0637.05437.00.070.060.150.070.070.45