{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T03:52:50Z","timestamp":1789876370213,"version":"4.0.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Bonn"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been observed in immunocompromised hosts. Early monotherapy with direct-acting antivirals or monoclonal antibodies, as recommended by the international guidelines, does not prevent this with certainty. Dual therapies may therefore have a synergistic effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective, multicentre study compared treatment strategies for corona virus disease-19 (COVID-19) with combinations of nirmatrelvir\/ritonavir, remdesivir, molnupiravir, and\/ or mABs during the Omicron surge. Co-primary endpoints were prolonged viral shedding (\u2265\u200910\n                      <jats:sup>6<\/jats:sup>\n                      copies\/ml at day 21 after treatment initiation) and days with SARS-CoV-2 viral load\u2009\u2265\u200910\n                      <jats:sup>6<\/jats:sup>\n                      copies\/ml. Therapeutic strategies and risk groups were compared using odds ratios and Fisher\u2019s tests or Kaplan\u2212Meier analysis and long-rank tests. Multivariable regression analysis was performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      144 patients were included with a median duration of SARS-CoV-2 viral load\u2009\u2265\u200910\n                      <jats:sup>6<\/jats:sup>\n                      copies\/ml of 8.0\u00a0days (IQR 6.0\u201315.3). Underlying haematological malignancies (HM) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) and treatment initiation later than five days after diagnosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) were significantly associated with longer viral shedding. Prolonged viral shedding was observed in 14.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921\/144), particularly in patients with underlying HM (OR 3.5; 95% CI 1.2\u20139.9;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Clinical courses of COVID-19 were mild to moderate with only few adverse effects potentially related to combination treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early combination treatment of COVID-19 effectively prevented prolonged viral shedding in 85.6% of cases. Considering the rapid viral clearance rates and low toxicity, individualized dual therapy approaches may be beneficial in high-risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-023-02125-5","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T20:01:51Z","timestamp":1701201711000},"page":"877-889","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Early combination therapy of COVID-19 in high-risk patients"],"prefix":"10.1007","volume":"52","author":[{"given":"Hans Martin","family":"Orth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Flasshove","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Berger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Hattenhauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaja D.","family":"Biederbick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekka","family":"Mispelbaum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Klein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jannik","family":"Stemler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthis","family":"Fisahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna D.","family":"Doleschall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben-Niklas","family":"Baermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Koenigshausen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Tselikmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Killer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"de Angelis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smaranda","family":"Gliga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Stegbauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolai","family":"Spuck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerda","family":"Silling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen K.","family":"Rockstroh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian P.","family":"Strassburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Brossart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens P.","family":"Panse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn-Erik Ole","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Luedde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Boesecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annkristin","family":"Heine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver A.","family":"Cornely","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8794-3612","authenticated-orcid":false,"given":"Malte B.","family":"Monin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"2125_CR1","unstructured":"Therapeutics and COVID-19: living guideline, 14 July 2022. Geneva: World Health Organization. 2022."},{"key":"2125_CR2","doi-asserted-by":"publisher","first-page":"1813","DOI":"10.1056\/NEJMoa2007764","volume":"383","author":"JH Beigel","year":"2020","unstructured":"Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, et al. Remdesivir for the treatment of Covid-19\u2014final report. N Engl J Med. 2020;383:1813\u201326.","journal-title":"N Engl J Med"},{"key":"2125_CR3","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.1056\/NEJMoa2118542","volume":"386","author":"J Hammond","year":"2022","unstructured":"Hammond J, Leister-Tebbe H, Gardner A, Abreu P, Bao W, Wisemandle W, et al. Oral nirmatrelvir for high-risk, nonhospitalized adults with Covid-19. N Engl J Med. 2022;386:1397\u2013408.","journal-title":"N Engl J Med"},{"key":"2125_CR4","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1056\/NEJMoa2116044","volume":"386","author":"A Jayk Bernal","year":"2022","unstructured":"Jayk Bernal A, Gomes da Silva MM, Musungaie DB, Kovalchuk E, Gonzalez A, Delos Reyes V, et al. Molnupiravir for oral treatment of Covid-19 in nonhospitalized patients. N Engl J Med. 2022;386:509\u201320.","journal-title":"N Engl J Med."},{"key":"2125_CR5","unstructured":"Understanding Risk for Severe COVID-19. COVID-19 real-time learning Network. Last Update January 17, 2023 Accessed: April 29, 2023]; Available from: https:\/\/www.idsociety.org\/covid-19-real-time-learning-network\/disease-manifestations--complications\/understanding-risk-for-severe-covid-19\/#."},{"key":"2125_CR6","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.jinf.2023.01.024","volume":"86","author":"SW Kang","year":"2023","unstructured":"Kang SW, Kim JW, Kim JY, Lim SY, Jang CY, Chang E, et al. Characteristics and risk factors of prolonged viable virus shedding in immunocompromised patients with COVID-19: a prospective cohort study. J Infect. 2023;86:412\u20134.","journal-title":"J Infect"},{"key":"2125_CR7","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1093\/cid\/ciac802","volume":"76","author":"S Gliga","year":"2023","unstructured":"Gliga S, Lubke N, Killer A, Gruell H, Walker A, Dilthey AT, et al. Rapid selection of sotrovimab escape variants in severe acute respiratory syndrome coronavirus 2 omicron-infected immunocompromised patients. Clin Infect Dis. 2023;76:408\u201315.","journal-title":"Clin Infect Dis"},{"key":"2125_CR8","doi-asserted-by":"publisher","first-page":"5530","DOI":"10.3390\/cancers14225530","volume":"14","author":"C Cattaneo","year":"2022","unstructured":"Cattaneo C, Salmanton-Garcia J, Marchesi F, El-Ashwah S, Itri F, Weinbergerova B, et al. Simultaneous Onset of Haematological Malignancy and COVID: An Epicovideha Survey. Cancers (Basel). 2022;14:5530.","journal-title":"Cancers (Basel)"},{"key":"2125_CR9","doi-asserted-by":"publisher","first-page":"1475","DOI":"10.3390\/microorganisms10071475","volume":"10","author":"A Gidari","year":"2022","unstructured":"Gidari A, Sabbatini S, Schiaroli E, Bastianelli S, Pierucci S, Busti C, et al. The combination of molnupiravir with nirmatrelvir or GC376 has a synergic role in the inhibition of SARS-CoV-2 replication in vitro. Microorganisms. 2022;10:1475.","journal-title":"Microorganisms"},{"key":"2125_CR10","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2022.105430","volume":"208","author":"JH Jeong","year":"2022","unstructured":"Jeong JH, Chokkakula S, Min SC, Kim BK, Choi WS, Oh S, et al. Combination therapy with nirmatrelvir and molnupiravir improves the survival of SARS-CoV-2 infected mice. Antiviral Res. 2022;208: 105430.","journal-title":"Antiviral Res"},{"key":"2125_CR11","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.166485","author":"K Rosenke","year":"2023","unstructured":"Rosenke K, Lewis MC, Feldmann F, Bohrnsen E, Schwarz B, Okumura A, et al. Combined molnupiravir-nirmatrelvir treatment improves the inhibitory effect on SARS-CoV-2 in macaques. JCI Insight. 2023. https:\/\/doi.org\/10.1172\/jci.insight.166485.","journal-title":"JCI Insight"},{"key":"2125_CR12","doi-asserted-by":"publisher","first-page":"1072202","DOI":"10.3389\/fphar.2022.1072202","volume":"13","author":"R Abdelnabi","year":"2022","unstructured":"Abdelnabi R, Maes P, de Jonghe S, Weynand B, Neyts J. Combination of the parent analogue of remdesivir (GS-441524) and molnupiravir results in a markedly potent antiviral effect in SARS-CoV-2 infected Syrian hamsters. Front Pharmacol. 2022;13:1072202.","journal-title":"Front Pharmacol"},{"key":"2125_CR13","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/j.jaci.2021.10.031","volume":"149","author":"LK Brown","year":"2022","unstructured":"Brown LK, Moran E, Goodman A, Baxendale H, Bermingham W, Buckland M, et al. Treatment of chronic or relapsing COVID-19 in immunodeficiency. J Allergy Clin Immunol. 2022;149:557-561 e1.","journal-title":"J Allergy Clin Immunol"},{"key":"2125_CR14","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1080\/1120009X.2023.2196917","volume":"35","author":"M Lanzafame","year":"2023","unstructured":"Lanzafame M, Gottardi M, Guella L, Collini L, Costa G, Guella A, et al. Successful treatment of persistent SARS-CoV-2 infection with nirmatrelvir\/ritonavir plus sotrovimab in four immunocompromised patients. J Chemother. 2023;35:623\u20136.","journal-title":"J Chemother"},{"key":"2125_CR15","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1093\/cid\/ciad181","volume":"77","author":"M Mikulska","year":"2023","unstructured":"Mikulska M, Sepulcri C, Dentone C, Magne F, Balletto E, Baldi F, et al. Triple combination therapy with two antivirals and monoclonal antibodies for persistent or relapsed SARS-CoV-2 infection in immunocompromised patients. Clin Infect Dis. 2023;77:280\u20136.","journal-title":"Clin Infect Dis"},{"key":"2125_CR16","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/S1473-3099(22)00733-2","volume":"23","author":"P Arora","year":"2023","unstructured":"Arora P, Kempf A, Nehlmeier I, Schulz SR, Jack HM, Pohlmann S, et al. Omicron sublineage BQ.1.1 resistance to monoclonal antibodies. Lancet Infect Dis. 2023;23:22\u20133.","journal-title":"Lancet Infect Dis"},{"key":"2125_CR17","doi-asserted-by":"publisher","first-page":"1980","DOI":"10.1007\/s11606-022-07511-7","volume":"37","author":"M Rubio-Rivas","year":"2022","unstructured":"Rubio-Rivas M, Mora-Lujan JM, Formiga F, Arevalo-Canas C, Lebron Ramos JM, Villalba Garcia MV, et al. WHO ordinal scale and inflammation risk categories in COVID-19 comparative study of the severity scales. J Gen Intern Med. 2022;37:1980\u20137.","journal-title":"J Gen Intern Med."},{"key":"2125_CR18","unstructured":"Underlying Medical Conditions Associated with Higher Risk for Severe COVID-19: Information for Healthcare Professionals. Last updated: Feb. 9, 2023 Accessed: May 1, 2023]; Available from: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/clinical-care\/underlyingconditions.html."},{"key":"2125_CR19","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1111\/bjh.18690","volume":"201","author":"M Mikulska","year":"2023","unstructured":"Mikulska M, Testi D, Russo C, Balletto E, Sepulcri C, Bussini L, et al. Outcome of early treatment of SARS-CoV-2 infection in patients with haematological disorders. Br J Haematol. 2023;201:628\u201339.","journal-title":"Br J Haematol"},{"key":"2125_CR20","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.jhin.2022.11.018","volume":"132","author":"T Jefferson","year":"2023","unstructured":"Jefferson T, Spencer EA, Conly JM, Rosca EC, Maltoni S, Brassey J, et al. Viral cultures, cycle threshold values and viral load estimation for assessing SARS-CoV-2 infectiousness in haematopoietic stem cell and solid organ transplant patients: a systematic review. J Hosp Infect. 2023;132:62\u201372.","journal-title":"J Hosp Infect"},{"key":"2125_CR21","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.ajem.2022.01.028","volume":"54","author":"B Long","year":"2022","unstructured":"Long B, Carius BM, Chavez S, Liang SY, Brady WJ, Koyfman A, et al. Clinical update on COVID-19 for the emergency clinician: presentation and evaluation. Am J Emerg Med. 2022;54:46\u201357.","journal-title":"Am J Emerg Med"},{"key":"2125_CR22","doi-asserted-by":"publisher","first-page":"200","DOI":"10.3390\/vaccines11020200","volume":"11","author":"R Scotto","year":"2023","unstructured":"Scotto R, Buonomo AR, Iuliano A, Foggia M, Sardanelli A, Villari R, et al. Remdesivir alone or in combination with monoclonal antibodies as an early treatment to prevent severe COVID-19 in patients with mild\/moderate disease at high risk of progression: a single centre, real-life study. Vaccines (Basel). 2023;11:200.","journal-title":"Vaccines (Basel)"},{"key":"2125_CR23","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1056\/NEJMc2119407","volume":"386","author":"E Takashita","year":"2022","unstructured":"Takashita E, Kinoshita N, Yamayoshi S, Sakai-Tagawa Y, Fujisaki S, Ito M, et al. Efficacy of antibodies and antiviral drugs against Covid-19 omicron variant. N Engl J Med. 2022;386:995\u20138.","journal-title":"N Engl J Med"},{"key":"2125_CR24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2023.10.022","author":"S Meijer","year":"2023","unstructured":"Meijer S, Tau L, Dekel M, Cohen R, Katchman E, Ablin J, et al. Dual anti-viral treatment for chronic COVID-19 in immunocompromised hemato-oncological patients is associated with a favorable prognosis and few side effects. J Infect Chemother. 2023. https:\/\/doi.org\/10.1016\/j.jiac.2023.10.022.","journal-title":"J Infect Chemother"},{"key":"2125_CR25","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1002\/cpt.2646","volume":"112","author":"C Marzolini","year":"2022","unstructured":"Marzolini C, Kuritzkes DR, Marra F, Boyle A, Gibbons S, Flexner C, et al. Recommendations for the management of drug-drug interactions between the COVID-19 antiviral nirmatrelvir\/ritonavir (paxlovid) and comedications. Clin Pharmacol Ther. 2022;112:1191\u2013200.","journal-title":"Clin Pharmacol Ther"},{"key":"2125_CR26","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1016\/j.transproceed.2022.04.015","volume":"54","author":"M Prikis","year":"2022","unstructured":"Prikis M, Cameron A. Paxlovid (nirmatelvir\/ritonavir) and tacrolimus drug-drug interaction in a kidney transplant patient with SARS-2-CoV infection: a case report. Transplant Proc. 2022;54:1557\u201360.","journal-title":"Transplant Proc"},{"key":"2125_CR27","unstructured":"Sciences, G. Study to Evaluate the Efficacy and Safety of Remdesivir in Participants With Severely Reduced Kidney Function Who Are Hospitalized for Coronavirus Disease 2019 (COVID-19) (REDPINE). 2023 [cited 2023 June 19]; Available from: https:\/\/clinicaltrials.gov\/ct2\/show\/results\/NCT04745351?term=redpine&draw=2&rank=1&view=results#wrapper."},{"key":"2125_CR28","unstructured":"Refusal of the marketing authorisation for Lagevrio (molnupiravir). 2023 July 20, 2023]; Available from: https:\/\/www.ema.europa.eu\/en\/documents\/smop-initial\/questions-answers-refusal-marketing-authorisation-lagevrio-molnupiravir_en.pdf."},{"key":"2125_CR29","doi-asserted-by":"publisher","first-page":"100210","DOI":"10.1016\/j.clinpr.2022.100210","volume":"16","author":"D Hettle","year":"2022","unstructured":"Hettle D, Hutchings S, Muir P, Moran E, C.-G.U. consortium. Persistent SARS-CoV-2 infection in immunocompromised patients facilitates rapid viral evolution: Retrospective cohort study and literature review. Clin Infect Pract. 2022;16:100210.","journal-title":"Clin Infect Pract."}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-023-02125-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-023-02125-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-023-02125-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T12:05:14Z","timestamp":1733141114000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-023-02125-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,29]]},"references-count":29,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["2125"],"URL":"https:\/\/doi.org\/10.1007\/s15010-023-02125-5","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3259912\/v1","asserted-by":"object"}]},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,29]]},"assertion":[{"value":"13 August 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 October 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 November 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"H.M.O. received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Merck Serono GmbH. C.F. declares no conflicts of interest. M.B. declares no conflicts of interest. T.H. received support for attending meetings and\/or travel from Takeda and Jansen and participated on a Data Safety Monitoring Board or Advisory Board from Janssen. R.M. received support for attending meetings and\/or travel from Takeda and Jansen and participated on a Data Safety Monitoring Board or Advisory Board from Janssen. K.B. declares no conflicts of interest. U.K. declares no conflicts of interest. J.S. received Grants or contracts from Basilea Pharmaceuticals and the German Federal Ministry of Education and Research (BMBF), consulting fees from Gilead and Alvea Vax, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Gilead, AbbVie, and Pfizer, support for attending meetings and\/ or travel from the German Society for Infectious Diseases and the Meta-Alexander Foundation. He participated on a Data Safety Monitoring Board or Advisory Board by Alvea Vax and Micron Research. M.F. declares no conflicts of interest. A.D,D, declares no conflicts of interest. B-N.B. received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from from incyte and support for attending meetings and\/or travel from Kite\/Gilead and Medac. E.K. declares no conflicts of interest. O.T. declares no conflicts of interest. A.K. received support for attending meetings and\/or travel from Gilead and AbbVie and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Gilead. C.dA. declares no conflicts of interest. S.G. declares no conflicts of interest. J.S. declares no conflicts of interest. N.S. declares no conflicts of interest. G.S. declares no conflicts of interest. J.K.R. received Consulting fees from AbbVie, Boehringer, Gilead, Merck, and ViiV, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Gilead, Janssen, Merck, and ViiV; he has Leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid for EACS. C.P.S declares no conflicts of interest. P.B. declares no conflicts of interest. J.P. declares no conflicts of interest. B-E.O.J. received Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Gilead, ViiV, GSK, Pfizer, Janssen-Cilag, Fresenius Medical care, and the Falk Foundation, support for attending meetrings and\/ or travel from Gilead; he participated on a Data Safety Monitoring Board or Advisory Board from Gilead, ViiV, and Theratechnologies; he has Leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid for Scientific Secretary for German AIDS Society and member of STAKOB and COVRIIN working groups at Robert-Koch-Institute. T.L. declares no conflicts of interest. C.B. received Grants or contracts from DZIF, DFG, and NEAT ID, Consulting fees from Abbvie, Gilead, JnJ, MSD, and ViiV, Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Abbvie, Gilead, JnJ, MSD, and ViiV, support for attending meetings and\/or travel from Abbvie, Gilead, JnJ, MSD, and ViiV; he participated on a Data Safety Monitoring Board or Advisory Board from Mavmet Study. A.H. declares no conflicts of interest. O.A.C. reports grants or contracts from Amplyx, Basilea, BMBF, Cidara, DZIF, EU-DG RTD (101037867), F2G, Gilead, Matinas, MedPace, MSD, Mundipharma, Octapharma, Pfizer, Scynexis; Consulting fees from Abbvie, Amplyx, Biocon, Biosys, Cidara, Da Volterra, Gilead, IQVIA, Janssen, Matinas, MedPace, Menarini, Molecular Partners, MSG-ERC, Noxxon, Octapharma, Pfizer, PSI, Scynexis, Seres; Honoraria for lectures from Abbott, Abbvie, Al-Jazeera Pharmaceuticals, Astellas, Gilead, Grupo Biotoscana\/United Medical\/Knight, Hikma, MedScape, MedUpdate, Merck\/MSD, Mylan, Noscendo, Pfizer, Shionogi; Payment for expert testimony from Cidara; Participation on a Data Safety Monitoring Board or Advisory Board from Actelion, Allecra, Cidara, Entasis, IQVIA, Janssen, MedPace, Paratek, PSI, Pulmocide, Shionogi, The Prime Meridian Group; A patent at the German Patent and Trade Mark Office (DE 10 2021 113 007.7); Stocks from CoRe Consulting, EasyRadiology; Other interests from DGHO, DGI, ECMM, EHA, ISHAM, MSG-ERC, Wiley. M.B.M. received Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Gilead, Pfizer, Gilead Sciences, AstraZeneca, and Virology Education, and support for attending meetings and\/or travel from Gilead.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Due to the retrospective study design, ethical approval and\/or patient information was not required according to the North Rhine-Westphalian legislation.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}