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Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan

OBJECTIVES: To evaluate the effectiveness of remdesivir in the early stage of nonsevere COVID-19. Although several randomized controlled trials have compared the effectiveness of remdesivir with that of a placebo, there is limited evidence regarding its effect in the early stage of nonsevere COVID-1...

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Autores principales: Tsuzuki, Shinya, Hayakawa, Kayoko, Uemura, Yukari, Shinozaki, Tomohiro, Matsunaga, Nobuaki, Terada, Mari, Suzuki, Setsuko, Asai, Yusuke, Kitajima, Koji, Saito, Sho, Yamada, Gen, Shibata, Taro, Kondo, Masashi, Izumi, Kazuo, Hojo, Masayuki, Mizoue, Tetsuya, Yokota, Kazuhisa, Nakamura-Uchiyama, Fukumi, Saito, Fumitake, Sugiura, Wataru, Ohmagari, Norio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8857764/
https://www.ncbi.nlm.nih.gov/pubmed/35192953
http://dx.doi.org/10.1016/j.ijid.2022.02.039
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author Tsuzuki, Shinya
Hayakawa, Kayoko
Uemura, Yukari
Shinozaki, Tomohiro
Matsunaga, Nobuaki
Terada, Mari
Suzuki, Setsuko
Asai, Yusuke
Kitajima, Koji
Saito, Sho
Yamada, Gen
Shibata, Taro
Kondo, Masashi
Izumi, Kazuo
Hojo, Masayuki
Mizoue, Tetsuya
Yokota, Kazuhisa
Nakamura-Uchiyama, Fukumi
Saito, Fumitake
Sugiura, Wataru
Ohmagari, Norio
author_facet Tsuzuki, Shinya
Hayakawa, Kayoko
Uemura, Yukari
Shinozaki, Tomohiro
Matsunaga, Nobuaki
Terada, Mari
Suzuki, Setsuko
Asai, Yusuke
Kitajima, Koji
Saito, Sho
Yamada, Gen
Shibata, Taro
Kondo, Masashi
Izumi, Kazuo
Hojo, Masayuki
Mizoue, Tetsuya
Yokota, Kazuhisa
Nakamura-Uchiyama, Fukumi
Saito, Fumitake
Sugiura, Wataru
Ohmagari, Norio
author_sort Tsuzuki, Shinya
collection PubMed
description OBJECTIVES: To evaluate the effectiveness of remdesivir in the early stage of nonsevere COVID-19. Although several randomized controlled trials have compared the effectiveness of remdesivir with that of a placebo, there is limited evidence regarding its effect in the early stage of nonsevere COVID-19 cases. METHODS: We evaluated the effectiveness of remdesivir in the early stage of nonsevere COVID-19 using the COVID-19 Registry Japan, a nationwide registry of hospitalized patients with COVID-19 in Japan. Two regimens (“start remdesivir” therapy within 4 days from admission versus no remdesivir during hospitalization) among patients without the need for supplementary oxygen therapy were compared by a 3-step processing (cloning, censoring, and weighting) method. The primary outcome was a supplementary oxygen requirement during hospitalization. Secondary outcomes were 30-day in-hospital mortality and the risk of invasive mechanical ventilation or extracorporeal membrane oxygenation (IMV/ECMO). The data of 12,487 cases met our inclusion criteria. The “start remdesivir” regimen showed a lower risk of supplementary oxygen requirement (hazard ratio [HR]: 0.850, 95% confidence interval [CI]: 0.798–0.906, p value < 0.001). Both 30-day in-hospital mortality and risk of IMV/ECMO introduction were not significantly different between the 2 regimens (HRs: 1.04 and 0.983, 95% CI: 0.980–1.09 and 0.906–1.07, p values: 0.210 and 0.678, respectively). CONCLUSIONS: Remdesivir might reduce the risk of oxygen requirement during hospitalization in the early stage of COVID-19; however, it had no positive effect on the clinical outcome and reduction in IMV/ECMO requirement.
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spelling pubmed-88577642022-02-22 Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan Tsuzuki, Shinya Hayakawa, Kayoko Uemura, Yukari Shinozaki, Tomohiro Matsunaga, Nobuaki Terada, Mari Suzuki, Setsuko Asai, Yusuke Kitajima, Koji Saito, Sho Yamada, Gen Shibata, Taro Kondo, Masashi Izumi, Kazuo Hojo, Masayuki Mizoue, Tetsuya Yokota, Kazuhisa Nakamura-Uchiyama, Fukumi Saito, Fumitake Sugiura, Wataru Ohmagari, Norio Int J Infect Dis Article OBJECTIVES: To evaluate the effectiveness of remdesivir in the early stage of nonsevere COVID-19. Although several randomized controlled trials have compared the effectiveness of remdesivir with that of a placebo, there is limited evidence regarding its effect in the early stage of nonsevere COVID-19 cases. METHODS: We evaluated the effectiveness of remdesivir in the early stage of nonsevere COVID-19 using the COVID-19 Registry Japan, a nationwide registry of hospitalized patients with COVID-19 in Japan. Two regimens (“start remdesivir” therapy within 4 days from admission versus no remdesivir during hospitalization) among patients without the need for supplementary oxygen therapy were compared by a 3-step processing (cloning, censoring, and weighting) method. The primary outcome was a supplementary oxygen requirement during hospitalization. Secondary outcomes were 30-day in-hospital mortality and the risk of invasive mechanical ventilation or extracorporeal membrane oxygenation (IMV/ECMO). The data of 12,487 cases met our inclusion criteria. The “start remdesivir” regimen showed a lower risk of supplementary oxygen requirement (hazard ratio [HR]: 0.850, 95% confidence interval [CI]: 0.798–0.906, p value < 0.001). Both 30-day in-hospital mortality and risk of IMV/ECMO introduction were not significantly different between the 2 regimens (HRs: 1.04 and 0.983, 95% CI: 0.980–1.09 and 0.906–1.07, p values: 0.210 and 0.678, respectively). CONCLUSIONS: Remdesivir might reduce the risk of oxygen requirement during hospitalization in the early stage of COVID-19; however, it had no positive effect on the clinical outcome and reduction in IMV/ECMO requirement. The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2022-05 2022-02-19 /pmc/articles/PMC8857764/ /pubmed/35192953 http://dx.doi.org/10.1016/j.ijid.2022.02.039 Text en © 2022 The Author(s) Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Tsuzuki, Shinya
Hayakawa, Kayoko
Uemura, Yukari
Shinozaki, Tomohiro
Matsunaga, Nobuaki
Terada, Mari
Suzuki, Setsuko
Asai, Yusuke
Kitajima, Koji
Saito, Sho
Yamada, Gen
Shibata, Taro
Kondo, Masashi
Izumi, Kazuo
Hojo, Masayuki
Mizoue, Tetsuya
Yokota, Kazuhisa
Nakamura-Uchiyama, Fukumi
Saito, Fumitake
Sugiura, Wataru
Ohmagari, Norio
Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan
title Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan
title_full Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan
title_fullStr Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan
title_full_unstemmed Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan
title_short Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan
title_sort effectiveness of remdesivir in hospitalized nonsevere patients with covid-19 in japan: a large observational study using the covid-19 registry japan
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8857764/
https://www.ncbi.nlm.nih.gov/pubmed/35192953
http://dx.doi.org/10.1016/j.ijid.2022.02.039
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