Pharmacological treatment in pregnant women with moderate symptoms of coronavirus disease 2019 (COVID-19) pneumonia

Nasrallah, Sebastian; Nguyen, Anh Quoc; Hitchings, Laura; Wang, Jenny Q.; Hamade, Sara; Maxwell, G. Larry; Khoury, Alfred; Gómez, Luis M.

doi:10.1080/14767058.2021.1903426

Cited by 18 publications

(38 citation statements)

References 18 publications

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“…Among pregnant women with SARS-CoV-2 infection, the administration of 5-day remdesivir could clinically improve moderate COVID-19 [17], consistent with the finding in the general population [32]. Furthermore, Burwick et al also reported that 10-day remdesivir administration could clinically improve severe COVID-19 in pregnant and postpartum patients [16].…”

Section: Discussionsupporting

confidence: 70%

“…Multivariate analysis revealed a significantly longer recovery time in pregnant women who already received mechanical ventilation at baseline (hazard ratio, 0.34 [95% confidence interval, .20-.59]; P ¼ 0.0001) [16]. A cohort study evaluated clinical recovery based on remdesivir administration time after hospital admission [17]. Clinical recovery reached 100% (17/17) at hospitalization day 7 among patients who received remdesivir within 48 h from admission.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…Ten observational studies reported laboratory outcomes [16,17,18,19,20,22,24,25,26,27]. In cohort studies, 67% of participants had treatment-emergent-graded laboratory abnormalities based on the criteria of "The Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Event version 2.1."…”

Section: Laboratory Outcomesmentioning

confidence: 99%

“… One spontaneous miscarriage at 17 gestational weeks occurred in a 32-year-old woman, owing to concurrent bacteremia, tricuspid valve endocarditis, and septic arthritis. AST grade 1 = 10 (16%), grade 2 = 12 (19%), grade 3 = 3 (5%), grade 4 = 0 (0%) Creatinine grade 1 = 2 (3%), grade 2 = 5 (8%), grade 3 = 1 (2%), grade 4 = 3 (5%) Nasrallah et al., 2021 [ 17 ] On HD7, 100% of patients who received remdesivir <48 h after admission recovered; 0% of patients who started remdesivir >48 h after admission recovered; and 27% of patients treated without remdesivir recovered. Remdesivir <48 h from admission = 7 days, Remdesivir >48 h from admission = 9–18 days Laboratory test on admission: Remdesivir <48 h from admission AST (IU/L): 37 (22–90); ALT (IU/L): 30 (14–76); creatinine (mg/dL): 0.6 (0.5–0.7) 0 0 Elevated transaminase (8) Pregnancy outcome: Among 27 deliveries, 11 (40.7%) delivered via cesarean section.…”

Section: Introductionmentioning

confidence: 99%

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Remdesivir for pregnancy: A systematic review of antiviral therapy for COVID-19

Budi

Pratama

Wafa

et al. 2022

Heliyon

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The use of remdesivir for pregnant patients with coronavirus disease 2019 (COVID-19) showed conflicting results in prior studies. We aimed to systematically review its efficacy and safety for this population from the existing literature. Methods: On July 26, 2021, registries (ClinicalTrials.gov) and databases (MEDLINE, ScienceDirect, Cochrane Library, JSTOR, DOAJ, and medRxiv) were systematically searched for research articles investigating remdesivir use in pregnant people with COVID-19. Clinical outcome, hospitalization duration, laboratory outcome, mortality, and adverse events were investigated. Results: We obtained 13 observation studies with 113 pregnant people. In these studies, remdesivir improved the clinical condition of pregnant patients with COVID-19, especially those who had a better clinical status at baseline and received earlier remdesivir treatment. Most fetuses were delivered via cesarean section, primarily because of emergency causes. No vertical transmissions were noted. The most reported adverse event was transaminitis, in which 10-day remdesivir treatment yielded more incidence than the 5-day treatment. Conclusions: In pregnancy, the use of Remdesivir in combination with other COVID-19 treatments is inconclusive but its use should be followed with careful monitoring of adverse reactions and transaminase enzyme levels. Further studies are required to confirm its finding.

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Section: Discussionsupporting

confidence: 70%

Section: Clinical Outcomesmentioning

confidence: 99%

Section: Laboratory Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Remdesivir for pregnancy: A systematic review of antiviral therapy for COVID-19

Budi

Pratama

Wafa

et al. 2022

Heliyon

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“…Additional cohort studies, case series, and reports of remdesivir in pregnancy have not raised new safety concerns but lack appropriate comparator groups to properly assess relevant maternal and neonatal outcomes. 32,[57][58][59][60][61][62][63][64][65] Increases in transaminases have been described in both pregnant and non-pregnant individuals treated with remdesivir. 57,61,65,66 Liver enzyme abnormalities might be related to remdesivir, COVID-19, other pregnancy-related (e.g., preeclampsia), or unrelated causes.…”

Section: Remdesivirmentioning

confidence: 99%

The Incidence, Severity, and Management of COVID-19 in Critically Ill Pregnant Individuals

Munshi¹,

Wright²,

Zipursky³

et al. 2021

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Remdesivir in pregnant women with moderate to severe coronavirus disease 2019 (COVID-19): a retrospective cohort study

et al. 2023

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Data on the efficacy of remdesivir in Coronavirus Disease 2019 (COVID-19) are limited in pregnant patients since they have been excluded from clinical trials. We aimed to investigate some clinical outcomes following remdesivir administration in pregnancy. This was a retrospective cohort study conducted on pregnant women with moderate to severe COVID-19. The enrolled patients were divided into two groups with and without remdesivir treatment. The primary outcomes of this study were the length of hospital and intensive care unit stay; respiratory parameters of hospital day 7 including respiratory rate, oxygen saturation, and mode of oxygen support; discharge until days 7 and 14, and need for home oxygen therapy. Secondary outcomes included some maternal and neonatal consequences. Eighty-one pregnant women (57 in the remdesivir group and 24 in the non-remdesivir group) were included. The two study groups were comparable according to the baseline demographic and clinical characteristics. Of the respiratory outcomes, remdesivir was significantly associated with a reduced length of hospital stay ( p = 0.021) and also with a lower level of oxygen requirement in patients on low-flow oxygen [odds ratio (OR) 3.669]. Among the maternal consequences, no patients in the remdesivir group developed preeclampsia but three patients (12.5%) experienced this complication in the non-remdesivir group ( p = 0.024). Furthermore, in patients with moderate COVID-19, the percentage of emergency termination was significantly lower in remdesivir group (OR 2.46). Our results demonstrated some probable benefits of remdesivir in respiratory and also maternal outcomes. Further investigations with a larger sample size should confirm these results. Supplementary Information The online version contains supplementary material available at 10.1007/s10238-023-01095-0.

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Pharmacological treatment in pregnant women with moderate symptoms of coronavirus disease 2019 (COVID-19) pneumonia

Cited by 18 publications

References 18 publications

Remdesivir for pregnancy: A systematic review of antiviral therapy for COVID-19

Remdesivir for pregnancy: A systematic review of antiviral therapy for COVID-19

The Incidence, Severity, and Management of COVID-19 in Critically Ill Pregnant Individuals

Remdesivir in pregnant women with moderate to severe coronavirus disease 2019 (COVID-19): a retrospective cohort study

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