Efficacy and Safety of Remdesivir in COVID-19 Patients: A Retrospective Analysis of Active Surveillance Database

Abstract

Background: Real-world data on safety and efficacy of remdesivir in COVID‑19 management is scant. We present findings of data analysis conducted for assessing the clinical outcomes of remdesivir treatment for COVID-19 in India. Methods: This retrospective analysis used data from an active surveillance programme database of hospitalised patients with COVID-19 who were receiving remdesivir. Results: Of the 2329 patients included, 67.4% were men. Diabetes (29.69%) and hypertension (20.33%) were the most common comorbidities. At remdesivir initiation, 2272 (97.55%) patients were receiving oxygen therapy. Remdesivir was administered for 5 days in 65.38% of patients. Antibiotics (64.9%) and steroids (47.9%) were the most common concomitant medications. Remdesivir was overall well tolerated: 13% of patients reported 119 adverse events; most common were nausea and vomiting in 45.4% and increased liver enzymes in 14.28% patients. 84% of patients were cured/improved, 6.02% died, and 9.16% showed no improvement in their clinical status at data collection. Subgroup analysis showed that the mortality rate was significantly lower in patients < 60 years old than in those > 60 years old. Amongst patients on oxygen therapy, the cure/improvement rate was significantly higher in those receiving standard low-flow oxygen than in those receiving mechanical ventilation, non-invasive ventilation, or high-flow oxygen. Risk factors for higher mortality were age > 60 years, hypertension, cardiac disease, diabetes, and mechanical ventilation. Conclusion: Our analysis showed that remdesivir is well tolerated and has an acceptable safety profile. The cure/improvement rate was 84%, with a higher improvement in patients < 60 years old and on standard low-flow oxygen.

Therapeutic Effectiveness and Safety of Repurposing Drugs for the Treatment of COVID-19: Position Standing in 2021

“…A retrospective cohort study in Korea involving 86 severe COVID-19 patients hospitalized between June 1 and July 31, 2020, suggested better clinical and virologic effectiveness of remdesivir compared to supportive care in the case of mechanical ventilator requirement (22.9 vs. 44.7%, p = 0.032), mechanical ventilator duration (average, 1.97 vs. 5.37 days; p = 0.017), and viral load reduction (increase of cycle threshold (Ct) values: average, 10.19 vs. 5.36; p = 0.007 and the slope of Ct value increase: average, 5.10 vs. 2.68; p = 0.007) ( Joo et al, 2021 ). Another retrospective analysis demonstrated a well-tolerated safety profile of remdesivir and 84% improvement rate of the drug in COVID-19 patients ( Gupte et al, 2021 ). On the contrary, a large observational study in Japan concluded that remdesivir may not have any benefit on hospitalized COVID-19 patients’ clinical outcomes and reductions in need of invasive/non-invasive respiratory support.…”

The Implementation of Inspiratory Muscle Training to Enhance Weaning from Mechanical Ventilation: A Systematic Literature Review

“…Mechanical ventilation plays an important role in the world of critical care. The role of mechanical ventilation can be used as a substitute for ventilation in patients with lung disorders (Giusti et al, 2021;Gupte et al, 2022). However, mechanical ventilation can also cause respiratory muscle weakness among patients in the intensive care unit (ICU) (Walsh et al, 2021).…”