Efficacy and Safety of Remdesivir over Two Waves of the SARS-CoV-2 Pandemic

Poliseno, Mariacristina; Gallo, Crescenzio; Cibelli, Donatella; Minafra, Graziano; Bottalico, Irene Francesca; Bruno, Serena Rita; D’Errico, Maria Maddalena; Montemurro, Laura; Rizzo, Marianna; Barbera, Lucia; Custodero, Giacomo Emanuele; Marca, Antonella La; Muzio, Donatella Lo; Miucci, Anna; Santantonio, T.; Caputo, Sergio Lo

doi:10.3390/antibiotics10121477

Cited by 6 publications

(13 citation statements)

References 34 publications

(81 reference statements)

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“…Some reports have shown little or no impact from this treatment, either alone or in association with steroids, on clinically relevant outcomes such as intensive care unit (ICU) admission or mortality [ 7 , 8 , 9 , 10 ]. Conversely, other studies suggested that it could be useful, as an add-on treatment, in adults with persistent fever and dyspnea and moderate lung involvement on chest CT, reducing ICU admission, length of hospital stay, and even mortality [ 11 , 12 , 13 , 14 , 15 ], especially when administered in the first 5 days of symptoms [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Co-Administration of Remdesivir and Azithromycin May Protect against Intensive Care Unit Admission in COVID-19 Pneumonia Requiring Hospitalization: A Real-Life Observational Study

et al. 2022

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The benefits of remdesivir treatment, with or without co-administration of antibiotics such as azithromycin, are uncertain in COVID-19 pneumonia. The aim of this retrospective single-center study was to assess the effects of remdesivir, with or without azithromycin, on hospital mortality, intensive care unit (ICU) admission, and need of non-invasive ventilation. The clinical records of the COVID-19 patients hospitalized in an Italian ward in March 2021 were analyzed, and data on comorbidities and clinical, radiological, and laboratory presentation of the disease were collected. Among 394 participants (234 M), 173 received remdesivir (43.9%), including 81 with azithromycin (20.5%). Remdesivir recipients were younger, with less comorbidities, and had better PaO2/FiO2 and clinical outcomes, including reduced mortality, but the differences were not independent of covariates. Rates of ICU transferal were 17%, 9%, and 1% in the no remdesivir, remdesivir without azithromycin, and remdesivir/azithromycin groups, respectively. In a stepwise multivariate logistic regression model, remdesivir/azithromycin co-treatment was independently associated with reduced ICU admission (vs remdesivir alone, OR 0.081, 95% CI 0.008–0.789, p = 0.031; vs no remdesivir, OR 0.060, 95% CI 0.007–0.508, p = 0.010). These data suggest that the therapeutical effect of remdesivir in COVID-19 pneumonia may be potentiated by azithromycin. The association between the two drugs should be further investigated.

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Section: Introductionmentioning

confidence: 99%

Co-Administration of Remdesivir and Azithromycin May Protect against Intensive Care Unit Admission in COVID-19 Pneumonia Requiring Hospitalization: A Real-Life Observational Study

et al. 2022

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“…However, they observed a reduction in heart rate, but there was no cardiovascular system (CVS) toxicity even with severe CVS comorbidity. 20 A recent review article also found a similar safety profile. Multiple‐dose of remdesivir resulted in reversible hepatocellular enzyme elevations, but there was no renal or hepatic toxicity.…”

Section: Remdesivirmentioning

confidence: 75%

“…According to a group of scientists focusing on renal, cardiac, and hepatic safety, they found remdesivir causing no significant changes in glomerular filtration rate and liver enzymes even in impaired patients. However, they observed a reduction in heart rate, but there was no cardiovascular system (CVS) toxicity even with severe CVS comorbidity 20 . A recent review article also found a similar safety profile.…”

Section: Remdesivirmentioning

confidence: 83%

“… 19 Studies also reported its efficacy against most variants of coronavirus. 20 Several studies supported that there is a clear safety profile of remdesivir. According to a group of scientists focusing on renal, cardiac, and hepatic safety, they found remdesivir causing no significant changes in glomerular filtration rate and liver enzymes even in impaired patients.…”

Section: Remdesivirmentioning

confidence: 99%

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Comparative evaluation of authorized drugs for treating Covid‐19 patients

Islam

Hasan

Rahman

et al. 2022

Health Science Reports

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Background and Aims Vaccines are the first line of defense against coronavirus disease 2019 (Covid‐19). However, the antiviral drugs provide a new tool to fight the Covid‐19 pandemic. Here we aimed for a comparative evaluation of authorized drugs for treating Covid‐19 patients. Methods We searched in PubMed and Google Scholar using keywords and terms such as Covid, SARS‐CoV‐2, Coronavirus disease 2019, therapeutic management, hospitalized Covid‐19 patients, Covid‐19 treatment. We also gathered information from reputed newspapers, web portals, and websites. We thoroughly observed, screened, and included the studies relevant to our inclusion criteria. We included only the United States Food and Drug Administration (FDA) authorized drugs for this review. Results We found that molnupiravir and paxlovid are available for oral use, and remdesivir is for only hospitalized patients. Paxlovid is a combination of nirmatrelvir and ritonavir, nirmatrelvir is a protease inhibitor (ritonavir increases the concentration of nirmatrelvir), and the other two (remdesivir and molnupiravir) are nucleoside analog prodrugs. Remdesivir and molnupiravir doses do not need to adjust in renal and hepatic impairment. However, the paxlovid dose adjustment is required for mild to moderate renal or hepatic impaired patients. Also, the drug is not allowed for Covid‐19 patients with severe renal or hepatic impairment. Preliminary studies showed oral antiviral drugs significantly reduce hospitalization or death among mild to severe patients. Moreover, the US FDA has approved four monoclonal antibodies for Covid‐19 treatment. Studies suggest that these drugs would reduce the risk of hospitalization or severity of symptoms. World Health Organization strongly recommended the use of corticosteroids along with other antiviral drugs for severe or critically hospitalized patients. Conclusion All authorized drugs are effective in inhibiting viral replication for most SARS‐CoV‐2 variants. Therefore, along with vaccines, these drugs might potentially aid in fighting the Covid‐19 pandemic.

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“…For patients with SARS-CoV-2 pneumonia, Poliseno and the other researchers on the Foggia team present a very relevant case history on the use of remdesivir and its efficacy and safety profile [ 7 ]. Their data show a low rate of ICU admission, a high rate of clinical recovery and good drug safety observed in COVID-19 patients treated with remdesivir during two distinct pandemic waves.…”

mentioning

confidence: 99%