Early administration of remdesivir may reduce mortality in hospitalized COVID-19 patients: A propensity score matched analysis

BACKGROUND: Remdesivir is the only antiviral agent approved for the treatment of hospitalized coronavirus disease 2019 (COVID-19) patients requiring supplemental oxygen. Studies show conflicting results regarding its effect on mortality. METHODS: In this single center observational study, we include...

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Detalles Bibliográficos
Autores principales: Karolyi, Mario, Kaltenegger, Lukas, Pawelka, Erich, Kuran, Avelino, Platzer, Moritz, Totschnig, David, Koenig, Franz, Hoepler, Wolfgang, Laferl, Hermann, Omid, Sara, Seitz, Tamara, Traugott, Marianna, Arthofer, Sigrun, Erlbeck, Lea, Jaeger, Stefan, Kettenbach, Alina, Assinger, Alice, Wenisch, Christoph, Zoufaly, Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2022
Materias:
Original Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9610353/
https://www.ncbi.nlm.nih.gov/pubmed/36301355
http://dx.doi.org/10.1007/s00508-022-02098-9
Descripción
Sumario:BACKGROUND: Remdesivir is the only antiviral agent approved for the treatment of hospitalized coronavirus disease 2019 (COVID-19) patients requiring supplemental oxygen. Studies show conflicting results regarding its effect on mortality. METHODS: In this single center observational study, we included adult hospitalized COVID-19 patients. Patients who were treated with remdesivir were compared to controls. Remdesivir was administered for 5 days. To adjust for any imbalances in our cohort, a propensity score matched analysis was performed. The aim of our study was to analyze the effect of remdesivir on in-hospital mortality and length of stay (LOS). RESULTS: After propensity score matching, 350 patients (175 remdesivir, 175 controls) were included in our analysis. Overall, in-hospital mortality was not significantly different between groups remdesivir 5.7% [10/175] vs. control 8.6% [15/175], hazard ratio 0.50, 95% confidence interval (CI) 0.22–1.12, p = 0.091. Subgroup analysis showed a significant reduction of in-hospital mortality in patients who were treated with remdesivir ≤ 7 days of symptom onset remdesivir 4.2% [5/121] vs. control 10.4% [13/125], hazard ratio 0.26, 95% CI 0.09 to 0.75, p = 0.012 and in female patients remdesivir 2.9% [2/69] vs. control 12.2% [9/74], hazard ratio 0.18 95%CI 0.04 to 0.85, p = 0.03. Patients in the remdesivir group had a significantly longer LOS (11 days vs. 9 days, p = 0.046). CONCLUSION: Remdesivir did not reduce in-hospital mortality in our whole propensity score matched cohort, but subgroup analysis showed a significant mortality reduction in female patients and in patients treated within ≤ 7 days of symptom onset. Remdesivir may reduce mortality in patients who are treated in the early stages of illness. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s00508-022-02098-9) contains supplementary material, which is available to authorized users.

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