Cargando…

Efficacy of Remdesivir-Containing Therapy in Hospitalized COVID-19 Patients: A Prospective Clinical Experience

Objectives: Remdesivir is currently approved for the treatment of COVID-19. The recommendation for using remdesivir in patients with COVID-19 was based on the in vitro and in vivo activity of this drug against SARS-CoV-2. Methods: This was a prospective observational study conducted on a population...

Descripción completa

Detalles Bibliográficos
Autores principales: Russo, Alessandro, Binetti, Erica, Borrazzo, Cristian, Cacciola, Elio Gentilini, Battistini, Luigi, Ceccarelli, Giancarlo, Mastroianni, Claudio Maria, d’Ettorre, Gabriella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432083/
https://www.ncbi.nlm.nih.gov/pubmed/34501233
http://dx.doi.org/10.3390/jcm10173784
_version_ 1783751081661038592
author Russo, Alessandro
Binetti, Erica
Borrazzo, Cristian
Cacciola, Elio Gentilini
Battistini, Luigi
Ceccarelli, Giancarlo
Mastroianni, Claudio Maria
d’Ettorre, Gabriella
author_facet Russo, Alessandro
Binetti, Erica
Borrazzo, Cristian
Cacciola, Elio Gentilini
Battistini, Luigi
Ceccarelli, Giancarlo
Mastroianni, Claudio Maria
d’Ettorre, Gabriella
author_sort Russo, Alessandro
collection PubMed
description Objectives: Remdesivir is currently approved for the treatment of COVID-19. The recommendation for using remdesivir in patients with COVID-19 was based on the in vitro and in vivo activity of this drug against SARS-CoV-2. Methods: This was a prospective observational study conducted on a population of patients hospitalized for COVID-19. The primary endpoint of this study was the impact of remdesivir-containing therapy on 30-day mortality; the secondary endpoint was the impact of remdesivir-containing therapy on the need for high-flow oxygen therapy (HFNC), non-invasive ventilation (NIV), or mechanical ventilation. The data were analyzed after propensity score matching. Results: A total of 407 patients with SARS-CoV-2 pneumonia were consecutively enrolled. Out of these, 294 (72.2%) were treated with remdesivir and 113 (27.8%) were not. Overall, 61 patients (14.9%) were treated during hospitalization with HFNC, NIV, or mechanical ventilation, while 30-day mortality was observed in 21 patients (5.2%). Univariate analysis of patients treated with remdesivir or not showed no differences in 30-day mortality (4% vs. 6%, p = 0.411) in the two study groups. Cox regression analysis, after propensity score matching, showed that therapies, including remdesivir-containing therapy, were not statistically associated with 30-day survival or mortality. The Kaplan–Meier curves of 30-day survival in patients treated with remdesivir or not before (p = 0.24) and after (p = 0.88) propensity score matching showed no differences between the two study groups. Finally, patients treated with remdesivir or not showed the same need for HFNC/NIV or mechanical ventilation. Conclusions: This real-life experience of remdesivir use in hospitalized patients with COVID-19 was not associated with significant increases in rates of survival or reduced use of HFNC/NIV or mechanical ventilation compared with patients treated with other therapies not including remdesivir.
format Online
Article
Text
id pubmed-8432083
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-84320832021-09-11 Efficacy of Remdesivir-Containing Therapy in Hospitalized COVID-19 Patients: A Prospective Clinical Experience Russo, Alessandro Binetti, Erica Borrazzo, Cristian Cacciola, Elio Gentilini Battistini, Luigi Ceccarelli, Giancarlo Mastroianni, Claudio Maria d’Ettorre, Gabriella J Clin Med Article Objectives: Remdesivir is currently approved for the treatment of COVID-19. The recommendation for using remdesivir in patients with COVID-19 was based on the in vitro and in vivo activity of this drug against SARS-CoV-2. Methods: This was a prospective observational study conducted on a population of patients hospitalized for COVID-19. The primary endpoint of this study was the impact of remdesivir-containing therapy on 30-day mortality; the secondary endpoint was the impact of remdesivir-containing therapy on the need for high-flow oxygen therapy (HFNC), non-invasive ventilation (NIV), or mechanical ventilation. The data were analyzed after propensity score matching. Results: A total of 407 patients with SARS-CoV-2 pneumonia were consecutively enrolled. Out of these, 294 (72.2%) were treated with remdesivir and 113 (27.8%) were not. Overall, 61 patients (14.9%) were treated during hospitalization with HFNC, NIV, or mechanical ventilation, while 30-day mortality was observed in 21 patients (5.2%). Univariate analysis of patients treated with remdesivir or not showed no differences in 30-day mortality (4% vs. 6%, p = 0.411) in the two study groups. Cox regression analysis, after propensity score matching, showed that therapies, including remdesivir-containing therapy, were not statistically associated with 30-day survival or mortality. The Kaplan–Meier curves of 30-day survival in patients treated with remdesivir or not before (p = 0.24) and after (p = 0.88) propensity score matching showed no differences between the two study groups. Finally, patients treated with remdesivir or not showed the same need for HFNC/NIV or mechanical ventilation. Conclusions: This real-life experience of remdesivir use in hospitalized patients with COVID-19 was not associated with significant increases in rates of survival or reduced use of HFNC/NIV or mechanical ventilation compared with patients treated with other therapies not including remdesivir. MDPI 2021-08-24 /pmc/articles/PMC8432083/ /pubmed/34501233 http://dx.doi.org/10.3390/jcm10173784 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Russo, Alessandro
Binetti, Erica
Borrazzo, Cristian
Cacciola, Elio Gentilini
Battistini, Luigi
Ceccarelli, Giancarlo
Mastroianni, Claudio Maria
d’Ettorre, Gabriella
Efficacy of Remdesivir-Containing Therapy in Hospitalized COVID-19 Patients: A Prospective Clinical Experience
title Efficacy of Remdesivir-Containing Therapy in Hospitalized COVID-19 Patients: A Prospective Clinical Experience
title_full Efficacy of Remdesivir-Containing Therapy in Hospitalized COVID-19 Patients: A Prospective Clinical Experience
title_fullStr Efficacy of Remdesivir-Containing Therapy in Hospitalized COVID-19 Patients: A Prospective Clinical Experience
title_full_unstemmed Efficacy of Remdesivir-Containing Therapy in Hospitalized COVID-19 Patients: A Prospective Clinical Experience
title_short Efficacy of Remdesivir-Containing Therapy in Hospitalized COVID-19 Patients: A Prospective Clinical Experience
title_sort efficacy of remdesivir-containing therapy in hospitalized covid-19 patients: a prospective clinical experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432083/
https://www.ncbi.nlm.nih.gov/pubmed/34501233
http://dx.doi.org/10.3390/jcm10173784
work_keys_str_mv AT russoalessandro efficacyofremdesivircontainingtherapyinhospitalizedcovid19patientsaprospectiveclinicalexperience
AT binettierica efficacyofremdesivircontainingtherapyinhospitalizedcovid19patientsaprospectiveclinicalexperience
AT borrazzocristian efficacyofremdesivircontainingtherapyinhospitalizedcovid19patientsaprospectiveclinicalexperience
AT cacciolaeliogentilini efficacyofremdesivircontainingtherapyinhospitalizedcovid19patientsaprospectiveclinicalexperience
AT battistiniluigi efficacyofremdesivircontainingtherapyinhospitalizedcovid19patientsaprospectiveclinicalexperience
AT ceccarelligiancarlo efficacyofremdesivircontainingtherapyinhospitalizedcovid19patientsaprospectiveclinicalexperience
AT mastroianniclaudiomaria efficacyofremdesivircontainingtherapyinhospitalizedcovid19patientsaprospectiveclinicalexperience
AT dettorregabriella efficacyofremdesivircontainingtherapyinhospitalizedcovid19patientsaprospectiveclinicalexperience