Background and ImportanceCOVID-19 results in hospitalisation or death in older patients and those with underlying conditions. Sotrovimab is a monoclonal antibody that was designed to prevent progression of COVID-19 in high-risk patients early in the course of disease.Aim and ObjectivesWe aimed to assess the efficacy and safety of sotrovimab for adults infected with COVID-19 in a 400-bed French hospital.Material and MethodsThis is a monocentric retrospective observational study conducted on 36 patients, which received sotrovimab from January to March 2022 in our hospital. Adult patients who had a positive result on rt-PCR or antigen SARS-CoV-2 testing and an onset of COVID-19 symptoms within the previous 5 days were eligible to treatment by sotrovimab. The patients were at high risk of progression because of older age (≥80y) or diabetes, obesity, chronic kidney disease, congestive heart failure, chronic obstructive pulmonary disease, asthma and cancer. All the patients provided written informed consent.ResultsOut of the 36 patients treated, mean age was 82.6 ± 9.5y with 80% patients≥75y, BMI 25.3 ± 4.7 and sex ratio 0.3. Almost all of them were living in nursing homes (30 patients). 83% had ≥2 conditions considered to be risk factors for progression of COVID-19. The most common risk factors were: age≥80, congestive heart failure and cancer. 30 patients( 83%) had received a complete schema of COVID-19 vaccine and 18 patients (50%) had already been infected with the SARS-CoV-2 virus. Among hospitalised patients, none who received sotrovimab was admitted to ICU. Among those living in nursing home, none was admitted to hospital. Most of the patients had few symptoms. 3 patients had disease progression leading to low flow oxygenation. 2 patients died the month following the infection, including 1 related to COVID-19. Among unvaccinated patients, 33% (2/6) had disease progression. 3 patients received corticosteroid, 5 anticoagulant and 4 antibiotic therapy. Adverse event was reported for 1 patient (itchy skin reaction) but none had serious adverse event.Conclusion and RelevanceSotrovimab reduces the risk of disease progression to hospitalisation or death among patients with mild-to-moderate COVID-19. This seems to be legit in our study, as does the safety, especially for elderly patients. Also, the effectiveness of this antibody against disease progression appears to be better for vaccinated patients.References and/or AcknowledgementsConflict of InterestNo conflict of interest.