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ABSTRACT: Introduction
Remdesivir is a registered treatment for hospitalised patients with COVID-19 that has moderate clinical effectiveness. Anecdotally, some patients' respiratory insufficiency seemed to recover particularly rapidly after initiation of remdesivir. In this study, we investigated if this rapid improvement was caused by remdesivir, and which patient characteristics might predict a rapid clinical improvement in response to remdesivir.Methods
This was a multicentre observational cohort study of hospitalised patients with COVID-19 who required supplemental oxygen and were treated with dexamethasone. Rapid clinical improvement in response to treatment was defined by a reduction of at least 1 L of supplemental oxygen per minute or discharge from the hospital within 72 h after admission. Inverse probability of treatment-weighted logistic regression modelling was used to assess the association between remdesivir and rapid clinical improvement. Secondary endpoints included in-hospital mortality, ICU admission rate and hospitalisation duration.Results
Of 871 patients included, 445 were treated with remdesivir. There was no influence of remdesivir on the occurrence of rapid clinical improvement (62% vs 61% OR 1.05, 95% CI 0.79-1.40; p = 0.76). The in-hospital mortality was lower (14.7% vs 19.8% OR 0.70, 95% CI 0.48-1.02; p = 0.06) for the remdesivir-treated patients. Rapid clinical improvement occurred more often in patients with low C-reactive protein (≤ 75 mg/L) and short duration of symptoms prior to hospitalisation (< 7 days) (OR 2.84, 95% CI 1.07-7.56).Conclusion
Remdesivir generally does not increase the incidence of rapid clinical improvement in hospitalised patients with COVID-19, but it might have an effect in patients with short duration of symptoms and limited signs of systemic inflammation.
SUBMITTER: Leegwater E
PROVIDER: S-EPMC10600071 | biostudies-literature | 2023 Oct
REPOSITORIES: biostudies-literature
Leegwater Emiel E Dol Lisa L Benard Menno R MR Roelofsen Eveline E EE Delfos Nathalie M NM van der Feltz Machteld M Mollema Femke P N FPN Bosma Liesbeth B E LBE Visser Loes E LE Ottens Thomas H TH van Burgel Nathalie D ND Arbous Sesmu M SM El Bouazzaoui Lahssan H LH Knevel Rachel R Groenwold Rolf H H RHH de Boer Mark G J MGJ Visser Leo G LG Rosendaal Frits R FR Wilms Erik B EB van Nieuwkoop Cees C
Infectious diseases and therapy 20231006 10
<h4>Introduction</h4>Remdesivir is a registered treatment for hospitalised patients with COVID-19 that has moderate clinical effectiveness. Anecdotally, some patients' respiratory insufficiency seemed to recover particularly rapidly after initiation of remdesivir. In this study, we investigated if this rapid improvement was caused by remdesivir, and which patient characteristics might predict a rapid clinical improvement in response to remdesivir.<h4>Methods</h4>This was a multicentre observatio ...[more]