TY - JOUR
T1 - Rapid Response to Remdesivir in Hospitalised COVID-19 Patients
T2 - A Propensity Score Weighted Multicentre Cohort Study
AU - Leegwater, Emiel
AU - Dol, Lisa
AU - Benard, Menno R.
AU - Roelofsen, Eveline E.
AU - Delfos, Nathalie M.
AU - van der Feltz, Machteld
AU - Mollema, Femke P.N.
AU - Bosma, Liesbeth B.E.
AU - Visser, Loes E.
AU - Ottens, Thomas H.
AU - van Burgel, Nathalie D.
AU - Arbous, Sesmu M.
AU - El Bouazzaoui, Lahssan H.
AU - Knevel, Rachel
AU - Groenwold, Rolf H.H.
AU - de Boer, Mark G.J.
AU - Visser, Leo G.
AU - Rosendaal, Frits R.
AU - Wilms, Erik B.
AU - van Nieuwkoop, Cees
N1 - Publisher Copyright: © 2023, The Author(s).
PY - 2023/10/6
Y1 - 2023/10/6
N2 - Introduction: Remdesivir is a registered treatment for hospitalised patients with COVID-19 that has moderate clinical effectiveness. Anecdotally, some patients’ respiratory insufficiency seemed to recover particularly rapidly after initiation of remdesivir. In this study, we investigated if this rapid improvement was caused by remdesivir, and which patient characteristics might predict a rapid clinical improvement in response to remdesivir. Methods: This was a multicentre observational cohort study of hospitalised patients with COVID-19 who required supplemental oxygen and were treated with dexamethasone. Rapid clinical improvement in response to treatment was defined by a reduction of at least 1 L of supplemental oxygen per minute or discharge from the hospital within 72 h after admission. Inverse probability of treatment-weighted logistic regression modelling was used to assess the association between remdesivir and rapid clinical improvement. Secondary endpoints included in-hospital mortality, ICU admission rate and hospitalisation duration. Results: Of 871 patients included, 445 were treated with remdesivir. There was no influence of remdesivir on the occurrence of rapid clinical improvement (62% vs 61% OR 1.05, 95% CI 0.79–1.40; p = 0.76). The in-hospital mortality was lower (14.7% vs 19.8% OR 0.70, 95% CI 0.48–1.02; p = 0.06) for the remdesivir-treated patients. Rapid clinical improvement occurred more often in patients with low C-reactive protein (≤ 75 mg/L) and short duration of symptoms prior to hospitalisation (< 7 days) (OR 2.84, 95% CI 1.07–7.56). Conclusion: Remdesivir generally does not increase the incidence of rapid clinical improvement in hospitalised patients with COVID-19, but it might have an effect in patients with short duration of symptoms and limited signs of systemic inflammation.
AB - Introduction: Remdesivir is a registered treatment for hospitalised patients with COVID-19 that has moderate clinical effectiveness. Anecdotally, some patients’ respiratory insufficiency seemed to recover particularly rapidly after initiation of remdesivir. In this study, we investigated if this rapid improvement was caused by remdesivir, and which patient characteristics might predict a rapid clinical improvement in response to remdesivir. Methods: This was a multicentre observational cohort study of hospitalised patients with COVID-19 who required supplemental oxygen and were treated with dexamethasone. Rapid clinical improvement in response to treatment was defined by a reduction of at least 1 L of supplemental oxygen per minute or discharge from the hospital within 72 h after admission. Inverse probability of treatment-weighted logistic regression modelling was used to assess the association between remdesivir and rapid clinical improvement. Secondary endpoints included in-hospital mortality, ICU admission rate and hospitalisation duration. Results: Of 871 patients included, 445 were treated with remdesivir. There was no influence of remdesivir on the occurrence of rapid clinical improvement (62% vs 61% OR 1.05, 95% CI 0.79–1.40; p = 0.76). The in-hospital mortality was lower (14.7% vs 19.8% OR 0.70, 95% CI 0.48–1.02; p = 0.06) for the remdesivir-treated patients. Rapid clinical improvement occurred more often in patients with low C-reactive protein (≤ 75 mg/L) and short duration of symptoms prior to hospitalisation (< 7 days) (OR 2.84, 95% CI 1.07–7.56). Conclusion: Remdesivir generally does not increase the incidence of rapid clinical improvement in hospitalised patients with COVID-19, but it might have an effect in patients with short duration of symptoms and limited signs of systemic inflammation.
UR - http://www.scopus.com/inward/record.url?scp=85173727865&partnerID=8YFLogxK
U2 - 10.1007/s40121-023-00874-2
DO - 10.1007/s40121-023-00874-2
M3 - Article
C2 - 37801280
AN - SCOPUS:85173727865
SN - 2193-8229
VL - 12
SP - 2471
EP - 2484
JO - Infectious Diseases and Therapy
JF - Infectious Diseases and Therapy
IS - 10
ER -
