Long-term survival benefit of male and multimorbid COVID-19 patients with 5-day remdesivir treatment

Abstract

Background Treatment of the coronavirus disease (COVID-19) is still challenging due to the lack of evidence-based treatment protocols and continuously changing epidemiological situations and vaccinations. Remdesivir (RDV) is among the few antiviral medications with confirmed efficacy for specific patient groups. However, real-world data on long-term outcomes for a short treatment course are scarce. Methods This retrospective observational cohort study included real-life data collected during the second and third wave of the COVID-19 pandemic in Hungary (September 1, 2020-April 30, 2021) from inpatients at a University Center (n = 947). Participants consisted of two propensity score-matched cohorts (370/370 cases): Group RDV including patients receiving RDV and supplementary oxygen and Group standard of care (SOC) as control. The primary outcome was the effect of 5-day RDV treatment on 30- and 60-day all-cause mortality. Multivariate analyses were performed to assess the effect of RDV by different covariates. Results Group RDV included significantly more patients from the alpha variant wave, with greater frequency of comorbidities diabetes and anemia, and larger degree of parenchymal involvement. All-cause mortality at 30- and 60-day were significantly lower in Group RDV compared to Group SOC. Significant risk reduction of 60-day all-cause mortality was observed for RDV treatment in men and patients with COPD or multiple comorbidities. Conclusions Hospitalized COVID-19 patients with 5-day RDV treatment had significantly lower 30- and 60-day all-cause mortality, despite their more severe clinical condition. Men and patients with multiple comorbidities, including COPD, profited the most from RDV treatment in the long term. Due to the ongoing COVID-19 pandemic, effective treatment regimens are needed for hospitalized patients.

Remdesivir: Effectiveness and safety in hospitalized patients with COVID-19 (ReEs-COVID19) - Analysis of data from daily practice

“…However, 30-days mortality (3.8%) was lower than that in the ACTT-1 (11%), WHO's Solidarity (15%) and DisCoVeRy (8%) trials (9,12,21). In most (22)(23)(24) but not all (25) observational studies 30-days mortality and/or disease progression rates in patients treated with 5day remdesivir were higher than in our study being around 12-13%. In a recently published Greek study, a 10% mortality rate was reported in three Greek hospitals (4% in 14 days), with a 9-day mean interval between admission and recovery [26].…”

Post-COVID interstitial lung disease in symptomatic patients after COVID-19 disease

“…Patients with ILD were started on steroid therapy, and a subsequent followup study assessed the reduction of previous symptoms and described the regression of CT abnormalities; highlighting that CT lesions did not progress to fibrosis in patients treated with steroids (Myall et al 2021). In our patients steroids were used during the hospital stay in high proportion as standard of care treatment, non-treated patients were mainly from the group of referrals who had their infection at home (Polivka et al 2022). This might have contributed to the lower number of pulmonary changes on LDCT.…”

Effectiveness of COVID-19 Vaccination with mRNA Vaccines for Patients with Cirrhosis in Hungary: Multicentre Matched Cohort Study

“…Based on our national protocol, indication for oxygen administration was arterial partial pressure of oxygen (PaO 2 ) <60 mm Hg or peripheral oxygen saturation (SpO 2 ) <90% at room air [ 16 ]. The initial strategy was a low-flow system up to 2 L/min via nasal cannulae and was increased over 6 to 15 L/min with reservoir facemask.…”

“…The initial strategy was a low-flow system up to 2 L/min via nasal cannulae and was increased over 6 to 15 L/min with reservoir facemask. For those requiring low-flow oxygen, a 5-day-long remdesivir regimen and dexamethasone 8–16 mg oral/8–16 iv were administered [ 16 ]. Patients with a persistent need for hig- flow oxygen (>60 L/min) or showing rapid progression over hours, hemodynamic instability or multiorgan failure needed mechanical ventilation.…”