Background Sotrovimab has been developed to neutralize SARS-CoV-2 which remained effective at the advent of B.1 lineage of the Omicron variant. To investigate post-infusion clinical events and their risk factors, we performed a retrospective study.Methods Subjects were a consecutive series of inpatients with COVID-19 undergoing an infusion of sotrovimab in our institute. In accordance with previous clinical trials, we included patients at risk but permitted SARS-CoV-2 vaccinees. For statistical analyses, we reviewed background factors of demographics, imaging, and laboratory findings for the outcome of post-infusion events such as temperature over 38 degrees Celsius (Temp38) and pulse oximetry below 94%.Results Of a total of 136 patients, the median follow-up was 47 days. Among 110 fully vaccinated patients (80.9%) for SARS-CoV-2, 2-time vaccinees accounted for 88 while 3-time vaccinees were 22. Three patients (2.2%) showed worsening of COVID-19; one developed hypoxia and two died. For the outcome of Temp38 (N=41), multivariate analysis showed that factors at risk were younger age (<66.5) (Odds Ratio [OR] 4.364, 95% Confidence Interval [CI] 1.562 – 12.194, P=0.005) and pre-infusion temperature more than 36.7 degrees Celsius (OR 7.256, 95% CI 2.695 – 21.455, P<0.001). For post-infusion reduced oximetry (N=17), symptomatic days (>2) (OR 8.657, 95% CI 1.030 – 72.786, P=0.047) and pulse oximetry (<96.5%) (OR 7.160, 95% CI 2.071 – 24.751, P=0.002) were at risk. Oxygen was supplied for a median of 1.5 days (range, 1 - 5). We observed vomiting (N=1) and elevated aminotransferase levels (N=1). Conclusions With fully vaccinated patients predominant, antibody-dependent enhancement may have brought about post-infusion fever in the younger population prone to increase antibody titers. Likewise, patients undergoing delayed infusion after symptom onset may have produced antibody, leading into respiratory distress or lowered oximetry. Limitations for this study included inherent difficulty in distinguishing AE from worsening of COVID-19. Thus for 24 hours after infusion of sotrovimab, COVID-19 patients younger than 66.5 years may have temperature elevation, indicating the need for preparation of post-infusion fever. Those undergoing infusion after 3 symptomatic days or more may develop an oximetry decrease, thus demanding pulse oximetry monitoring.

Background: To evaluate the efficacy of the GLadIus MG drilLINg technique (GLIMGLIN), a novel initial wiring technique using the Gladius MGTM structural features, for crossing the superficial femoral artery (SFA) with chronic total occlusion (CTO). Methods: This retrospective, single-center study enrolled 27 symptomatic patients (mean age 77.4±8.5 years; 20 men) with de novo SFA CTO (mean CTO length 16.1±8.9 cm) who underwent GLIMGLIN as the initial wiring between January 2020 and December 2021. The success of GLIMGLIN was defined when the wire crossing was completed using a Gladius MGTM and a microcatheter without any additional devices. GLIMGLIN was defined as one of the conventional wiring techniques.Results: The success rates of GLIMGLIN and conventional wiring were 48.1% and 74.1%, respectively. Intravascular ultrasound findings showed complete true lumen passage in the GLIMGLIN success group. Compared to the failure group, the proximal (6.3±0.8 vs. 5.5±0.9 mm, p=0.02) and distal (5.9±0.5 vs. 5.4±0.6 mm, p=0.02) reference vessel diameters were significantly larger, and the rate of calcium angle >180° was significantly fewer (30.8 vs. 71.4 %, p=0.04) in the success group. No significant difference was shown in the CTO length between the group. Total wiring time, total procedure time, and fluoroscopic time were significantly shorter in the success group. Conclusions: GLIMGLIN may enable operators to perform CTO wiring easily, efficiently, and at a lower cost in selected cases.