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Real-world outcomes of COVID-19 treatment with remdesivir in a Spanish hospital
Remdesivir is the only antiviral approved for lower respiratory tract infection produced by SARS-CoV-2. The main objective of this study was to determine the mortality rate, readmissions, mean hospital stay, need for higher levels of oxygen support, and adverse effect-induced abandonment rate in hos...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8448042/ https://www.ncbi.nlm.nih.gov/pubmed/34664862 http://dx.doi.org/10.1097/MD.0000000000027228 |
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author | Hidalgo-Tenorio, Carmen García-Vallecillos, Coral Sequera-Arquelladas, Sergio |
author_facet | Hidalgo-Tenorio, Carmen García-Vallecillos, Coral Sequera-Arquelladas, Sergio |
author_sort | Hidalgo-Tenorio, Carmen |
collection | PubMed |
description | Remdesivir is the only antiviral approved for lower respiratory tract infection produced by SARS-CoV-2. The main objective of this study was to determine the mortality rate, readmissions, mean hospital stay, need for higher levels of oxygen support, and adverse effect-induced abandonment rate in hospitalized patients diagnosed with COVID-19 and treated with remdesivir (RDSV). The secondary objective was to determine mortality-related risk factors in these patients. The study included a prospective cohort of patients admitted to a third level Spanish hospital between July 5, 2020 and February 3, 2021 for COVID-19 diagnosed by SARS-CoV-2 polymerase chain reaction and/or antigen test and treated with RDSV. Remdesivir was received by 185 patients (69.7% males) with a mean age of 62.5 years, median Charlson index of 3 (interquartile range [IQR]: 1–4), and median ambient air oxygen saturation of 91% (IQR: 90–93); 61.6% of patients had hyper-inflammatory syndrome at admission. Median time with symptoms before RDSV treatment was 5 days (IQR: 3–6) and the median hospital stay was 10 days (IQR: 7–15); 19 patients (10.3%) died after a median stay of 13.5 days (IQR: 9.7–24 days), 58 patients (12.9%) were admitted to ICU, 58 (31.4%) needed higher levels of oxygen support, 0.5% abandoned the treatment due to adverse effects, and there were no readmissions. The only mortality-related factor was the need for higher levels of oxygen support (odds ratio 12.02; 95% confidence interval 2.25–64.2). All studied patients were admitted to hospital with a diagnosis of COVID-19 and in respiratory failure, needing initial low-flow oxygen support, and all received RDSV within 1 week of symptom onset. The percent mortality was lower in these patients than was observed in all patients with severe COVID-19 admitted to our center (10.3% vs 20.3%, respectively). Despite receiving RDSV, 1 in 3 patients needed higher levels of oxygen support, the sole mortality-related factor. |
format | Online Article Text |
id | pubmed-8448042 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-84480422021-09-20 Real-world outcomes of COVID-19 treatment with remdesivir in a Spanish hospital Hidalgo-Tenorio, Carmen García-Vallecillos, Coral Sequera-Arquelladas, Sergio Medicine (Baltimore) 4900 Remdesivir is the only antiviral approved for lower respiratory tract infection produced by SARS-CoV-2. The main objective of this study was to determine the mortality rate, readmissions, mean hospital stay, need for higher levels of oxygen support, and adverse effect-induced abandonment rate in hospitalized patients diagnosed with COVID-19 and treated with remdesivir (RDSV). The secondary objective was to determine mortality-related risk factors in these patients. The study included a prospective cohort of patients admitted to a third level Spanish hospital between July 5, 2020 and February 3, 2021 for COVID-19 diagnosed by SARS-CoV-2 polymerase chain reaction and/or antigen test and treated with RDSV. Remdesivir was received by 185 patients (69.7% males) with a mean age of 62.5 years, median Charlson index of 3 (interquartile range [IQR]: 1–4), and median ambient air oxygen saturation of 91% (IQR: 90–93); 61.6% of patients had hyper-inflammatory syndrome at admission. Median time with symptoms before RDSV treatment was 5 days (IQR: 3–6) and the median hospital stay was 10 days (IQR: 7–15); 19 patients (10.3%) died after a median stay of 13.5 days (IQR: 9.7–24 days), 58 patients (12.9%) were admitted to ICU, 58 (31.4%) needed higher levels of oxygen support, 0.5% abandoned the treatment due to adverse effects, and there were no readmissions. The only mortality-related factor was the need for higher levels of oxygen support (odds ratio 12.02; 95% confidence interval 2.25–64.2). All studied patients were admitted to hospital with a diagnosis of COVID-19 and in respiratory failure, needing initial low-flow oxygen support, and all received RDSV within 1 week of symptom onset. The percent mortality was lower in these patients than was observed in all patients with severe COVID-19 admitted to our center (10.3% vs 20.3%, respectively). Despite receiving RDSV, 1 in 3 patients needed higher levels of oxygen support, the sole mortality-related factor. Lippincott Williams & Wilkins 2021-09-17 /pmc/articles/PMC8448042/ /pubmed/34664862 http://dx.doi.org/10.1097/MD.0000000000027228 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections. |
spellingShingle | 4900 Hidalgo-Tenorio, Carmen García-Vallecillos, Coral Sequera-Arquelladas, Sergio Real-world outcomes of COVID-19 treatment with remdesivir in a Spanish hospital |
title | Real-world outcomes of COVID-19 treatment with remdesivir in a Spanish hospital |
title_full | Real-world outcomes of COVID-19 treatment with remdesivir in a Spanish hospital |
title_fullStr | Real-world outcomes of COVID-19 treatment with remdesivir in a Spanish hospital |
title_full_unstemmed | Real-world outcomes of COVID-19 treatment with remdesivir in a Spanish hospital |
title_short | Real-world outcomes of COVID-19 treatment with remdesivir in a Spanish hospital |
title_sort | real-world outcomes of covid-19 treatment with remdesivir in a spanish hospital |
topic | 4900 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8448042/ https://www.ncbi.nlm.nih.gov/pubmed/34664862 http://dx.doi.org/10.1097/MD.0000000000027228 |
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