A new study led by researchers at the Nuffield Department of Primary Care Health Sciences has found that while an important COVID-19 treatment is safe to use, there are significant disparities in which patients receive it.
The research, published in Communications Medicine, examined the uptake and safety of Sotrovimab - a COVID-19 treatment approved for use in extremely clinically vulnerable patients. The study analysed data from over 1.2 million eligible patients in England, making it one of the largest real-world studies of the treatment to date.
The researchers found no increased risk of serious side effects requiring hospitalisation in the 2-28 days following Sotrovimab treatment. However, they identified concerning patterns in who received the treatment, with marked variations across ethnic groups.
Key findings:
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No safety concerns: The study found no increased risk of serious adverse outcomes following treatment.
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Variation in uptake: Uptake of Sotrovimab was highest among Indian (15.0%), Other Asian (13.7%), White (13.4%), and Bangladeshi (11.4%) patients.
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Lower uptake among Black patients: Black Caribbean (6.4%) and Black African (4.7%) patients were significantly less likely to receive the treatment.
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Overall treatment rates: Only 12.4% of eligible patients who tested positive for COVID-19 received Sotrovimab.
Important Implications for Healthcare Equity
The study’s findings raise concerns for healthcare policy, particularly as early studies showed that non-white ethnic groups experienced higher COVID-19 mortality rates during the pandemic. The disparities in treatment access identified by this research could potentially worsen existing health inequalities.
The study analysed data from patients treated between December 2021 and May 2022, examining both the safety profile of Sotrovimab and patterns in its distribution. The research team used high-quality national electronic health record databases, allowing them to investigate rare adverse events with unprecedented detail.
Professor Julia Hippisley-Cox, senior author of the study and Professor of Predictive Medicine at Queen Mary University of London said 'This is an important study demonstrating the real-world safety of a new treatment for severe COVID-19. However, its concerning to see, yet again, evidence of marked health inequalities in access to new treatment for patients from different communities which needs to serve as a call to action.'
Professor Sir Aziz Sheikh, an author of the study and Head of the Nuffield Department of Primary Care Health Sciences, commented: ‘Our findings demonstrate that while Sotrovimab is a safe treatment option for vulnerable COVID-19 patients, we need to address the clear inequalities in who receives it. This research provides crucial evidence that can help policymakers develop targeted interventions to ensure more equitable access to these potentially life-saving treatments.’
The research team suggests that healthcare providers should examine and address barriers to COVID-19 treatment access, particularly for underserved communities. They also recommend that similar studies be conducted in other countries to corroborate their findings regarding both safety and access patterns.
‘While it's reassuring that the evidence suggests Sotrovimab is a safe treatment for clinically vulnerable patients, our findings highlight an important and recurring theme in healthcare—unequal access to treatments,’ said Andrew Snelling, lead researcher on the study and Senior Data Scientist in the Nuffield Department of Primary Care Health Sciences. ‘The lower uptake among some ethnic groups raises important questions about potential barriers. Further research is needed to understand these disparities and ensure that all eligible patients can benefit equally from COVID-19 therapies.’
This research was supported by a patient and public involvement advisory panel, who emphasized the importance of identifying barriers to COVID-19 therapeutic uptake and understanding treatment-associated risks.