Effect of remdesivir post hospitalization for COVID-19 infection from the randomized SOLIDARITY Finland trial

Nevalainen, Olli; Horstia, Saana; Laakkonen, Sanna; Rutanen, Juha; Mustonen, Jussi M. J.; Kalliala, Ilkka; Ansakorpi, Hanna; Kreivi, Hanna-Riikka; Kuutti, Pauliina; Paajanen, Juuso; Parkkila, Seppo; Paukkeri, Erja-Leena; Perola, Markus; Pourjamal, Negar; Renner, Andreas; Rosberg, Tuomas; Rutanen, Taija; Savolainen, Joni; Ala‐Kokko, Tero; Antonen, Jaakko; Delany, Jutta; Ekroos, Heikki; Hankkio, Riina; Haukipää, Mia; Hetemäki, Iivo; Holma, Pia; Holmberg, Ville; Jalkanen, Ville; Jouppila, Jenni; Jämsänen, Toni; Järventie, Juuso; Järvinen, Petrus; Kauma, Heikki; Kilpeläinen, Tuomas P.; Komulainen, Riitta; Kuitunen, Ilari; Lamminmäki, Satu M. H.; Mattila, Tiina; Myllärniemi, Marjukka; Mäkinen, Laura K.; Mäntylä, Jarkko; Määttä, Gitte; Niskanen, Joni; Nykänen, Taina; Nyqvist, Miro; Partanen, Terhi; Patovirta, Riitta-Liisa; Puusti, Emmi; Reponen, Emma; Risku, Sari; Saalasti, Mari; Salonen, Päivi; Sinisalo, Marjatta U.; Sivenius, Katariina; Säilä, Petrus; Tuominen, Susanna; Haukka, Jari; Guyatt, Gordon; Tikkinen, Kari A.O.

doi:10.1038/s41467-022-33825-5

Cited by 24 publications

(10 citation statements)

References 14 publications

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“…Our finding that nimatrelvir/ritonavir treatment during acute infection is not associated with lower odds of Long COVID is consistent with the Bajema et al report from the VA that there was no difference in post-COVID conditions at 6 months [13]. Data on the effect of other acute therapies including remdesivir on Long COVID symptoms have been mixed, with Italian observational data suggesting a benefit with remdesivir [27], but the Finish randomized SOLIDARITY trial did not demonstrate a difference in Long COVID with remdesivir compared to placebo [28]. One study suggested a benefit from metformin but not ivermectin or fluvoxamine [29], but a randomized platform study did not find that doxazosin, fluvoxamine, fluvoxamine in combination with inhaled budesonide, interferon-lambda, ivermectin, or metformin had any impact on Long COVID symptoms or quality of life [30].…”

Section: Our Study In Context Of Studies Of Nirmatrelvir/ritonavir On...supporting

confidence: 80%

Association of Nirmatrelvir/Ritonavir Treatment with Long COVID Symptoms in an Online Cohort of Non-Hospitalized Individuals Experiencing Breakthrough SARS-CoV-2 Infection in the Omicron Era

Durstenfeld

Peluso²,

Lin³

et al. 2023

Preprint

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BackgroundOral nirmatrelvir/ritonavir is a treatment for COVID-19, but whether treatment during the acute phase reduces the risk of developing Long COVID is unknown.MethodsUsing the Covid Citizen Science (CCS) online cohort, we surveyed individuals who reported their first SARS-CoV-2 positive test between March and August 2022 regarding Long COVID symptoms. We excluded those who were pregnant, unvaccinated, hospitalized for COVID-19, or received other antiviral therapy. The primary exposure was oral nirmatrelvir/ritonavir. The primary outcome was the presence of any Long COVID symptoms reported on cross-sectional surveys in November and December 2022. We used propensity-score models and inverse probability of treatment weighting to adjust for differences in treatment propensity. Our secondary question was whether symptom or test positivity rebound were associated with Long COVID.Results4684 individuals met the eligibility criteria, of whom 988 (21.1%) were treated and 3696 (78.9%) were untreated; 353/988 (35.7%) treated and 1258/3696 (34.0%) untreated responded to the survey. Median age was 55 years and 66% were female. We did not identify an association between nirmatrelvir/ritonavir treatment and Long COVID symptoms (OR 1.15; 95%CI 0.80-1.64). Among n=666 treated with nirmatrelvir/ritonavir who responded who responded to questions about rebound, rebound symptoms or test positivity were not associated with Long COVID symptoms (OR 1.34; 95%CI 0.74-2.41; p=0.33).ConclusionsWithin this cohort, treatment with nirmatrelvir/ritonavir among vaccinated, non-hospitalized individuals was not associated with lower prevalence of Long COVID symptoms or severity of Long COVID. Experiencing rebound symptoms or test positivity is not strongly associated with developing Long COVID.

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Section: Our Study In Context Of Studies Of Nirmatrelvir/ritonavir On...supporting

confidence: 80%

Association of Nirmatrelvir/Ritonavir Treatment with Long COVID Symptoms in an Online Cohort of Non-Hospitalized Individuals Experiencing Breakthrough SARS-CoV-2 Infection in the Omicron Era

Durstenfeld

Peluso²,

Lin³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“… * Mixed-effects logistic regression adjusted for age >70 years, enrolment before June 16, 2020, and ventilated at baseline, and a random intercept for trial. The additional WHO Solidarity trial data provided only in-hospital mortality data, whereas all other RCTs (CATCO, 35 DisCoVeRy, 36 , 41 NOR Solidarity, 37 FIN Solidarity, 39 , 42 Wang et al, 38 ACTT-1, 8 and Spinner et al 9 ) also collected out-of-hospital mortality data. † Mixed-effects Cox model adjusted for age >70 years, enrolment before June 16, 2020, and ventilated at baseline, and a random intercept for trial.…”

Section: Resultsmentioning

confidence: 99%

Effects of remdesivir in patients hospitalised with COVID-19: a systematic review and individual patient data meta-analysis of randomised controlled trials

Amstutz

Speich

Mentré

et al. 2023

The Lancet Respiratory Medicine

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“…SOLIDARITY trial did not demonstrate long-term benefits (1 year of follow-up) of remdesivir in patients who had hospitalized due to COVID-19 [42]. We have not studied antivirals separately because subgroups were too small to give reliable information but evaluated all together they seem to protect from PCC (any symptom) at 3 months.…”

Section: Discussionmentioning

confidence: 99%

The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study

et al. 2023

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Purpose Oral antivirals (nirmatrelvir/ritonavir and molnupiravir), intravenous short treatment of remdesivir and anti-SARS-CoV-2 monoclonal antibodies (mAbs) have been used for early COVID-19 treatments in high risk of disease progression patients. The term long COVID has been used to refer to a range of new, returning, or ongoing symptoms after SARS-CoV-2 infection. Little is known about the impact of such therapies on long COVID. Methods This is a retrospective observational study, including all outpatients evaluated from April 2021 to March 2022 in Brescia, Lombardy, northern Italy. Patients were stratified in three groups: (a) treated with mAbs, (b) treated with antivirals drugs and (c) controls (patients eligible for a or b who refused treatment). Data were collected at baseline and at month 1 and 3 (data on self-reported symptoms were collected using a telephone-administered questionnaire). We assessed early COVID-19 therapies effectiveness in preventing hospitalization, death at 1 or 3 months and persisting symptoms at 3 months after the onset of SARS-CoV-2 infection. Results A total of 649 patients were included in the study, of which 242 (37.3%) were treated with mAbs, 197 (30.3%) with antiviral drugs and 210 (32.4%) were not treated. Patients most frequently reported cerebro-cardiovascular diseases (36.7%) followed by obesity (22%). Overall, 29 patients (4.5%) died or were hospitalized at 1 or 3-month follow-up. Death or hospitalization was positively associated with older ages, with a significant linear trend (OR 3.05; 95% CI 1.16–8.06, for patients aged 80 or more years compared to those aged less than 65). Data on long COVID at 3 months were available for 323 (49.8%) patients. A positive association emerged for females compared to men, with an OR of 2.14 (95% CI 1.30–3.53) for any symptoms. Conversely, inverse associations were found for treatment groups as compared to the control one, with significant estimates among patients treated with antiviral drugs for any symptoms (OR 0.43, 95% CI 0.21–0.87) and patients treated with mAbs for any neuro-behavioral symptoms (OR 0.48, 95% CI 0.25–0.92). Conclusions We report beneficial effect of early use of anti-SARS-CoV-2 antivirals and mAbs on long COVID.

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Effect of remdesivir post hospitalization for COVID-19 infection from the randomized SOLIDARITY Finland trial

Cited by 24 publications

References 14 publications

Association of Nirmatrelvir/Ritonavir Treatment with Long COVID Symptoms in an Online Cohort of Non-Hospitalized Individuals Experiencing Breakthrough SARS-CoV-2 Infection in the Omicron Era

Association of Nirmatrelvir/Ritonavir Treatment with Long COVID Symptoms in an Online Cohort of Non-Hospitalized Individuals Experiencing Breakthrough SARS-CoV-2 Infection in the Omicron Era

Effects of remdesivir in patients hospitalised with COVID-19: a systematic review and individual patient data meta-analysis of randomised controlled trials

The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study

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