Real-life use of remdesivir in hospitalized patients with COVID-19

García-Vidal, Carolina; Meira, Fernanda; Cózar-Llistó, Alberto; Dueñas, Gerard; Puerta‐Alcalde, Pedro; García‐Poutón, Nicole; Chumbita, Mariana; Cardozo, Celia; Hernández‐Meneses, Marta; Alonso-Navarro, Rodrigo; Rico, Verónica; Agüero, Daiana; Bodro, Marta; Morata, Laura; Jordan, Carlota; Lopera, Carlos Andrés Arango; Ambrosioni, Juan; Seguí, Ferran; Grafia, Nacho; Castro, Pedro; García, Felipe; Martínez, José Antonio; Sanjuan, Gemma; Soriano, A. Segado

doi:10.37201/req/018.2021

Cited by 24 publications

(25 citation statements)

References 15 publications

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“…Nevertheless, aspects such as the fact that the overall mortality, significant in the total study population of the ACTT-1 trial, reflects the huge COVID-19 heterogeneity in behavior in different patient subgroups and the difficulty of randomizing benefits coming from the highest sample size subgroup ( n = 232 in remdesivir group and n = 203 in placebo group) should be taken into account [ 10 ]. Furthermore, in a real-life cohort of patients with severe pneumonia receiving low-flow oxygen-therapy treated with remdesivir, the 30-day mortality rate observed was 4.1% [ 26 ], very similar to that reported in the ACTT-1 trial [ 10 ]. This suggests that the results observed in this study could be in line with reality.…”

Section: Discussionsupporting

confidence: 59%

Impact of Remdesivir on the Treatment of COVID-19 During the First Wave in Spain

et al. 2021

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Introduction Spain was one of the most affected countries during the first wave of COVID-19, having the highest mortality rate in Europe. The aim of this retrospective study is to estimate the impact that remdesivir—the first drug for COVID-19 approved in the EU—would have had in the first wave. Methods This study simulated the impact that remdesivir could have had on the Spanish National Health System (SNHS) capacity (bed occupancy) and the number of deaths that could have been prevented, based on two scenarios: a real-life scenario (without remdesivir) and an alternative scenario (with remdesivir). It considered the clinical results of the ACTT-1 trial in hospitalized patients with COVID-19 and pneumonia who required supplemental oxygen. The occupancy rates in general wards and ICUs were estimated in both scenarios. Results Remdesivir use could have prevented the admission of 2587 patients (43.75%) in the ICUs. It could have also increased the SNHS capacity in 5656 general wards beds and 1700 ICU beds, showing an increase in the number of beds available of 17.53% (95% CI 3.98%–24.42%) and 23.98% (95% CI 21.33%–28.22%), respectively, at the peak of the occupancy rates. Furthermore, remdesivir use could have prevented 7639 deaths due to COVID-19, which implies a 27.51% reduction (95% CI 14.25%–34.07%). Conclusions Remdesivir could have relieved the pressure on the SNHS and could have reduced the death toll, providing a better strategy for the management of COVID-19 during the first wave. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01804-9.

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Section: Discussionsupporting

confidence: 59%

Impact of Remdesivir on the Treatment of COVID-19 During the First Wave in Spain

et al. 2021

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“…Recent real-word studies reporting data on the use of remdesivir [17] also compared it with lopinavir/ritonavir [18]. Some important meta-analysis showed that COVID-19 patients receiving remdesivir showed significantly higher rates of recovery and hospital discharge with lower rates of serious adverse events when compared to patients receiving other treatments [19,20].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Remdesivir-Containing Therapy in Hospitalized COVID-19 Patients: A Prospective Clinical Experience

Russo

Binetti

Borrazzo

et al. 2021

JCM

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Objectives: Remdesivir is currently approved for the treatment of COVID-19. The recommendation for using remdesivir in patients with COVID-19 was based on the in vitro and in vivo activity of this drug against SARS-CoV-2. Methods: This was a prospective observational study conducted on a population of patients hospitalized for COVID-19. The primary endpoint of this study was the impact of remdesivir-containing therapy on 30-day mortality; the secondary endpoint was the impact of remdesivir-containing therapy on the need for high-flow oxygen therapy (HFNC), non-invasive ventilation (NIV), or mechanical ventilation. The data were analyzed after propensity score matching. Results: A total of 407 patients with SARS-CoV-2 pneumonia were consecutively enrolled. Out of these, 294 (72.2%) were treated with remdesivir and 113 (27.8%) were not. Overall, 61 patients (14.9%) were treated during hospitalization with HFNC, NIV, or mechanical ventilation, while 30-day mortality was observed in 21 patients (5.2%). Univariate analysis of patients treated with remdesivir or not showed no differences in 30-day mortality (4% vs. 6%, p = 0.411) in the two study groups. Cox regression analysis, after propensity score matching, showed that therapies, including remdesivir-containing therapy, were not statistically associated with 30-day survival or mortality. The Kaplan–Meier curves of 30-day survival in patients treated with remdesivir or not before (p = 0.24) and after (p = 0.88) propensity score matching showed no differences between the two study groups. Finally, patients treated with remdesivir or not showed the same need for HFNC/NIV or mechanical ventilation. Conclusions: This real-life experience of remdesivir use in hospitalized patients with COVID-19 was not associated with significant increases in rates of survival or reduced use of HFNC/NIV or mechanical ventilation compared with patients treated with other therapies not including remdesivir.

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“…After a median (IQR) 15 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) days, clinical recovery was observed in 197 pts (89%), 159 of whom also reported virological recovery after a median (IQR) 20 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) days.…”

Section: General Characteristics Of Study Populationmentioning

confidence: 99%

“…Up until nowadays, limited data exist regarding the use of Remdesivir in real life [ 22 , 23 , 24 , 25 , 26 ]. Could Remdesivir represent a therapeutic option in the current epidemiological scenario, considering the scarcity of valid therapeutic alternatives available and the frequent, rapid evolution of SARS-CoV-2 pneumonia also in patients with mild COVID-19 and recent symptom onset?…”

Section: Introductionmentioning

confidence: 99%

“…Differences reported in median (IQR) duration of hospital stay (16 (11-25) vs. 15 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) days, p = 0.412) and median (IQR) time to first negative SARS-CoV-2 PCR on nasal-pharyngeal swab (21 (13-35) vs. 19 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) days, p = 0.062) was also non-significant between the two Groups.…”

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confidence: 99%

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

et al. 2021

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The aim of this study is to describe the features, the outcomes, and the clinical issues related to Remdesivir administration of a cohort of 220 patients (pts) with COVID-19 hospitalized throughout the last two pandemic waves in Italy. One hundred and nine pts were enrolled from 1 September 2020, to 28 February 2021 (Group A) and 111 from 1 March to 30 September 2021 (Group B). Notably, no differences were reported between the two groups neither in the timing of hospitalization. nor in the timing of Remdesivir administration from symptoms onset. Remarkably, a higher proportion of pts with severe COVID-19 was observed in Group B (25% vs. 10%, p < 0.001). At univariate and multivariate analysis, rather than the timing of Remdesivir administration, age, presence of coexisting conditions, D-dimers, and O2 flow at admission correlated positively to progression to non-invasive ventilation, especially for patients in Group B. However, the rate of admission in the Intensive Care Unit and/or death was comparable in the two groups (7% vs. 4%). Negligible variations in serum GOT, GPT, GGT, and eGFR levels were detected. A mean reduction in heart rate was noticed within the first three days of antiviral treatment (p < 0.001). Low rate of ICU admission, high rate of clinical recovery, and good drug safety were observed in COVID-19 patients treated with Remdesivir during two diverse pandemic waves.

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Real-life use of remdesivir in hospitalized patients with COVID-19

Cited by 24 publications

References 15 publications

Impact of Remdesivir on the Treatment of COVID-19 During the First Wave in Spain

Impact of Remdesivir on the Treatment of COVID-19 During the First Wave in Spain

Efficacy of Remdesivir-Containing Therapy in Hospitalized COVID-19 Patients: A Prospective Clinical Experience

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

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