Prognostic factors of 30-day mortality in patients with COVID-19 pneumonia under standard remdesivir and dexamethasone treatment

Abstract

Although some studies have reported prognostic factors for coronavirus disease 2019 (COVID-19), they were conducted before standard treatment with remdesivir and dexamethasone was implemented. This retrospective, observational study was conducted to evaluate various prognostic factors in patients with COVID-19 pneumonia receiving standard treatment with remdesivir and dexamethasone. Of 99 patients with COVID-19 pneumonia, 68 (68.7%) died within 30 days of hospitalization. The mean age was 71.3 years. Remdesivir and dexamethasone were administered to 80 (80.8%) and 84 (84.8%) patients, respectively. Early antibiotic treatment was administered to 70 patients (70.7%) within 5 days of hospitalization. Dexamethasone (79.4% vs 96.8%, P = .033) was more frequently administered in the survived group, whereas early antibiotics (60.3% vs 93.5%, P = .001) were less frequently administered. In the multivariate analysis, a high National Early Warning Score (NEWS; odds ratio [OR] 1.272), high Charlson Comorbidity Index (CCI; OR 1.441), and dyspnea (OR 4.033) were independent risk factors for 30-day mortality. There was no significant difference in age, sex, and vaccination doses between the survived and fatal groups. Lymphopenia, monocytopenia and high levels of C-reactive protein (CRP)/lactate dehydrogenase (LDH) reflected poor prognosis. NEWS, CCI, and dyspnea were predictors of 30-day mortality in patients with COVID-19 pneumonia. Early antibiotic use did not lower the 30-day mortality risk. Abbreviations: CCI = Charlson Comorbidity Index, CI = confidence interval, COVID-19 = coronavirus disease 2019, CRP = C-reactive protein, LDH = lactate dehydrogenase, NEWS = National Early Warning Score, OR = odds ratio, pro-BNP = pro-B-type natriuretic peptide, RT-PCR = reverse transcription-polymerase chain reaction, SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.

Personalized Assessment of Mortality Risk and Hospital Stay Duration in Hospitalized Patients with COVID-19 Treated with Remdesivir: A Machine Learning Approach

“…In Choi YJ et al's study, multivariate analysis confirmed that a high National Early Warning Score (NEWS) and Charlson Comorbidity Index (CCI) at admission, along with dyspnea, were independent risk factors for 30-day mortality in COVID-19 pneumonia patients treated with remdesivir and dexamethasone [60]. NEWS is based on a scoring system that combines six key physiological measurements (respiratory rate, SpO2, temperature, systolic blood pressure, heart rate, and level of consciousness) upon hospital admission or monitoring.…”

“…These identified factors provide valuable insights into the potential determinants of adverse outcomes associated with remdesivir use. In the realm of research on factors influencing the response to remdesivir in hospitalized patients with COVID-19, few studies have been conducted [60][61][62].…”

Ethanol Inhalation in Treatment and Prevention of Coronavirus Disease (COVID-19)

“…It is interesting to note that ethanol completely inactivates Mycoplasma According to a recent trial, introducing early antibiotic therapy for COVID-19 pneumonia had no positive effects on 30-day mortality [27]. Despite what was predicted [28,29], the authors [27] did not discover any appreciable vaccination benefit in reducing illness severity and death among patients with COVID-19 pneumonia. The GSS fell more in the Intervention group than in the control group, according to our findings, and these data reached a statistically significant level (p = 0.016).…”

“…The abnormal presence of Mycoplasma salivarium in the lower tract or the lack of Clostridia in the upper tract was linked to worse outcomes in ICU patients [24]. It is interesting to note that ethanol completely inactivates Mycoplasma According to a recent trial, introducing early antibiotic therapy for COVID-19 pneumonia had no positive effects on 30-day mortality [27]. Despite what was predicted [28,29], the authors [27] did not discover any appreciable vaccination benefit in reducing illness severity and death among patients with COVID-19 pneumonia.…”

Efficacy and Safety of Inhalation of Nebulized Ethanol in COVID-19 Treatment: A Randomized Clinical Trial

“…The COVID-19 standard treatment includes intramuscular dexamethasone and remdesivir [ 22 ]. A recent study has shown no benefit on the 30-day mortality from adding early antibiotic treatment for COVID-19 pneumonia [ 28 ]. Contrary to expectations [ 29 , 30 ], the authors [ 28 ] did not find significant vaccine effectiveness in lowering disease severity and mortality among patients with COVID-19 pneumonia.…”