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Remdesivir treatment for patients with moderate to severe COVID-19

BACKGROUND/AIM: Remdesivir, which was first developed for the treatment of Ebola disease but failed to meet expectations, has become hope in the fight against the COVID-19 pandemic. This study aimed to evaluate risk factors for mortality and prognosis of adult moderate/severe COVID-19 patients treat...

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Autores principales: HASANOĞLU, İmran, GÜNER, Rahmet, ÇELİK, İlhami, KANAT, Fikret, BATIREL, Ayşe, TELLİ DİZMAN, Gülçin, EREN, Esma, YILDIZ SEVGİ, Dilek, BOZKURT, İlkay, KART YAŞAR, Kadriye, ŞENOĞLU, Sevtap, KAZAK, Esra, KARAALİ, Rıdvan, ÇELİKBAŞ, Aysel, PULLUKÇU, Hüsnü, ÇAĞATAY, Arif Atahan, ÜNAL, Serhat, ERDİNÇ, Şebnem, TABAK, Fehmi, GÜL, Ahmet, ALP, Emine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific and Technological Research Council of Turkey (TUBITAK) 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387889/
https://www.ncbi.nlm.nih.gov/pubmed/36326369
http://dx.doi.org/10.55730/1300-0144.5387
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author HASANOĞLU, İmran
GÜNER, Rahmet
ÇELİK, İlhami
KANAT, Fikret
BATIREL, Ayşe
TELLİ DİZMAN, Gülçin
EREN, Esma
YILDIZ SEVGİ, Dilek
BOZKURT, İlkay
KART YAŞAR, Kadriye
ŞENOĞLU, Sevtap
KAZAK, Esra
KARAALİ, Rıdvan
ÇELİKBAŞ, Aysel
PULLUKÇU, Hüsnü
ÇAĞATAY, Arif Atahan
ÜNAL, Serhat
ERDİNÇ, Şebnem
TABAK, Fehmi
GÜL, Ahmet
ALP, Emine
author_facet HASANOĞLU, İmran
GÜNER, Rahmet
ÇELİK, İlhami
KANAT, Fikret
BATIREL, Ayşe
TELLİ DİZMAN, Gülçin
EREN, Esma
YILDIZ SEVGİ, Dilek
BOZKURT, İlkay
KART YAŞAR, Kadriye
ŞENOĞLU, Sevtap
KAZAK, Esra
KARAALİ, Rıdvan
ÇELİKBAŞ, Aysel
PULLUKÇU, Hüsnü
ÇAĞATAY, Arif Atahan
ÜNAL, Serhat
ERDİNÇ, Şebnem
TABAK, Fehmi
GÜL, Ahmet
ALP, Emine
author_sort HASANOĞLU, İmran
collection PubMed
description BACKGROUND/AIM: Remdesivir, which was first developed for the treatment of Ebola disease but failed to meet expectations, has become hope in the fight against the COVID-19 pandemic. This study aimed to evaluate risk factors for mortality and prognosis of adult moderate/severe COVID-19 patients treated with remdesivir, and safety and tolerability of 5 days of remdesivir treatment. MATERIALS AND METHODS: This multicenter prospective observational study was conducted in 14 centers in Turkey. Pregnancy or breastfeeding, multiorgan failure, or usage of vasopressors for septic shock, ALT > 5 × the upper limit of the normal range, or eGRF <30 mL/min or dialysis and receiving favipiravir were the exclusion criteria of the study. RESULTS: Among 500 patients, 494 patients were included in the study. On admission, 392 (79.3%) patients had moderate and 102 (20.6%) patients had severe COVID-19. The 28-day mortality was 10.1%. The median of the scores of the seven-category ordinal scale assessed on days 0, 3, 5, 7 were 4 and 3 on day 14. When the survival status of the patients was evaluated according to the time between the remdesivir start date and the end date of the symptoms, no statistically significant difference was found between the medians of the groups (p = 0.404). In multivariable analysis, age (OR, 1.05; 95%CI, 1.02–1.08; p = 0.003), SpO(2) level on admission (OR, 3.03; 95%CI, 1.35–6.81; p = 0.007), heart rate (OR, 2.48; 95%CI, 1.01–6.07; p = 0.047), follow-up site at the hospital (clinic/ICU) (OR, 26.4; 95%CI, 11.6–60.17; p < 0.001) were independently associated with increased mortality. Grade 3 adverse event (AE) was observed in 4 (0.8%) patients. None of the patients experienced grade 4 or 5 AEs. CONCLUSION: Remdesivir is a safe and well-tolerated drug and older age, low SpO(2) level on admission, tachycardia, and ICU admission are independently associated with increased mortality among patients with moderate/severe COVID-19 receiving remdesivir treatment.
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spelling pubmed-103878892023-08-01 Remdesivir treatment for patients with moderate to severe COVID-19 HASANOĞLU, İmran GÜNER, Rahmet ÇELİK, İlhami KANAT, Fikret BATIREL, Ayşe TELLİ DİZMAN, Gülçin EREN, Esma YILDIZ SEVGİ, Dilek BOZKURT, İlkay KART YAŞAR, Kadriye ŞENOĞLU, Sevtap KAZAK, Esra KARAALİ, Rıdvan ÇELİKBAŞ, Aysel PULLUKÇU, Hüsnü ÇAĞATAY, Arif Atahan ÜNAL, Serhat ERDİNÇ, Şebnem TABAK, Fehmi GÜL, Ahmet ALP, Emine Turk J Med Sci Research Article BACKGROUND/AIM: Remdesivir, which was first developed for the treatment of Ebola disease but failed to meet expectations, has become hope in the fight against the COVID-19 pandemic. This study aimed to evaluate risk factors for mortality and prognosis of adult moderate/severe COVID-19 patients treated with remdesivir, and safety and tolerability of 5 days of remdesivir treatment. MATERIALS AND METHODS: This multicenter prospective observational study was conducted in 14 centers in Turkey. Pregnancy or breastfeeding, multiorgan failure, or usage of vasopressors for septic shock, ALT > 5 × the upper limit of the normal range, or eGRF <30 mL/min or dialysis and receiving favipiravir were the exclusion criteria of the study. RESULTS: Among 500 patients, 494 patients were included in the study. On admission, 392 (79.3%) patients had moderate and 102 (20.6%) patients had severe COVID-19. The 28-day mortality was 10.1%. The median of the scores of the seven-category ordinal scale assessed on days 0, 3, 5, 7 were 4 and 3 on day 14. When the survival status of the patients was evaluated according to the time between the remdesivir start date and the end date of the symptoms, no statistically significant difference was found between the medians of the groups (p = 0.404). In multivariable analysis, age (OR, 1.05; 95%CI, 1.02–1.08; p = 0.003), SpO(2) level on admission (OR, 3.03; 95%CI, 1.35–6.81; p = 0.007), heart rate (OR, 2.48; 95%CI, 1.01–6.07; p = 0.047), follow-up site at the hospital (clinic/ICU) (OR, 26.4; 95%CI, 11.6–60.17; p < 0.001) were independently associated with increased mortality. Grade 3 adverse event (AE) was observed in 4 (0.8%) patients. None of the patients experienced grade 4 or 5 AEs. CONCLUSION: Remdesivir is a safe and well-tolerated drug and older age, low SpO(2) level on admission, tachycardia, and ICU admission are independently associated with increased mortality among patients with moderate/severe COVID-19 receiving remdesivir treatment. Scientific and Technological Research Council of Turkey (TUBITAK) 2022-04-16 /pmc/articles/PMC10387889/ /pubmed/36326369 http://dx.doi.org/10.55730/1300-0144.5387 Text en © TÜBİTAK https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License.
spellingShingle Research Article
HASANOĞLU, İmran
GÜNER, Rahmet
ÇELİK, İlhami
KANAT, Fikret
BATIREL, Ayşe
TELLİ DİZMAN, Gülçin
EREN, Esma
YILDIZ SEVGİ, Dilek
BOZKURT, İlkay
KART YAŞAR, Kadriye
ŞENOĞLU, Sevtap
KAZAK, Esra
KARAALİ, Rıdvan
ÇELİKBAŞ, Aysel
PULLUKÇU, Hüsnü
ÇAĞATAY, Arif Atahan
ÜNAL, Serhat
ERDİNÇ, Şebnem
TABAK, Fehmi
GÜL, Ahmet
ALP, Emine
Remdesivir treatment for patients with moderate to severe COVID-19
title Remdesivir treatment for patients with moderate to severe COVID-19
title_full Remdesivir treatment for patients with moderate to severe COVID-19
title_fullStr Remdesivir treatment for patients with moderate to severe COVID-19
title_full_unstemmed Remdesivir treatment for patients with moderate to severe COVID-19
title_short Remdesivir treatment for patients with moderate to severe COVID-19
title_sort remdesivir treatment for patients with moderate to severe covid-19
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387889/
https://www.ncbi.nlm.nih.gov/pubmed/36326369
http://dx.doi.org/10.55730/1300-0144.5387
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