Remdesivir-based therapy improved recovery of patients with COVID-19 in the SARSTer multicentre, real-world study

Flisiak, Robert; Zarębska-Michaluk, Dorota; Berkan-Kawińska, Aleksandra; Tudrujek-Zdunek, Magdalena; Rogalska, Magdalena; Piekarska, Anna; Kozielewicz, Dorota; Kłos, Krzysztof; Rorat, Marta; Bolewska, Beata; Szymanek-Pasternak, Anna; Mazur, Włodzimierz; Lorenc, Beata; Podlasin, Regina; Sikorska, Katarzyna; Oczko-Grzesik, Barbara; Iwaszkiewicz, Cezary; Szetela, Bartosz; Pabjan, Paweł; Pawłowska, Małgorzata; Tomasiewicz, Krzysztof; Polańska, Joanna; Jaroszewicz, Jerzy

doi:10.20452/pamw.15735

Cited by 17 publications

(21 citation statements)

References 19 publications

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“…Entre os estudos de coorte encontrados, sete autores (Grein et al, 2020;Pasquini et al, 2020;Mendez-Echevaría et al, 2021;Flisiak et al, 2021;Ackley et al, 2021;Joo et al, 2021;Aiswarya et al, 2021) Como podemos observar, a maioria dos estudos encontrados relatou uma melhora no quadro dos pacientes tratados com Remdesivir, porém é importante ressaltar que a terapia com o medicamento também apresentou diversos efeitos colaterais, os quais podemos citar:…”

Section: Resultsunclassified

Uso do Remdesivir no tratamento da Covid-19: uma revisão integrativa

Malacrida

Santos

Pereira

et al. 2022

RSD

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O presente estudo teve por objetivo determinar a eficácia, efetividade e segurança do Remdesivir no tratamento para a Covid-19 através de uma revisão integrativa. A busca dos artigos foi realizada em março de 2021 nas bases de dados Pubmed, Scielo, Embase e Cochrane. Para guiar essa pesquisa, levantou-se a questão norteadora: “Qual o papel do Remdesivir no tratamento da Covid-19 em humanos?”. Foram utilizados os descritores “Covid ou Sars-Cov-2 ou Coronavirus” e “treatment” e “Remdesivir”. Os critérios de inclusão foram estudos primários originais que abordassem o tema proposto, disponíveis na integra, entre 2019-2021, nos idiomas português ou inglês. Dos 3012 artigos encontrados, foram utilizados 17 que atenderam os critérios de inclusão. A maioria dos estudos encontrados relatou uma melhora no quadro dos pacientes tratados com Remdesivir, porém é importante ressaltar que a terapia com o medicamento também apresentou diversos efeitos colaterais e não alterou o índice de mortalidade. Com base nos dados analisados, o Remdesivir demonstrou resultados promissores, sugerindo um perfil de risco-benefício favorável, porém até onde se foi observado, a tava de óbitos não foi alterada e seu uso prolongado pode desencadear efeitos colaterais indesejáveis.

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Section: Resultsunclassified

Uso do Remdesivir no tratamento da Covid-19: uma revisão integrativa

Malacrida

Santos

Pereira

et al. 2022

RSD

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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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“…Moreover, clinical improvement was analyzed with ordinal scale categories at consecutive time points on day 7, 14, 21, or 28 depending on baseline oxygen saturation (SpO2), patient’s age and molnupiravir administration within 5 days of symptom onset. This scale is based on WHO recommendations modified to fit the specificity of the national health care system as applied previously [12,13]. The ordinal scale was scored as follows: 1) unhospitalized, no activity restrictions; 2) unhospitalized, with limited activity; 3) hospitalized, does not require oxygen supplementation or medical care; 4) hospitalized, requiring no oxygen supplementation, but requiring medical care; 5) hospitalized, requiring normal oxygen supplementation; 6) hospitalized, on non-invasive ventilation with high-flow oxygen equipment; 7) hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 8) death.…”

Section: Methodsmentioning

confidence: 99%

Real-world experience with molnupiravir during the period of SARS-CoV-2 Omicron variant dominance

Flisiak

Zarębska-Michaluk

Rogalska

et al. 2022

Preprint

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Background. The real-world effectiveness of molnupiravir (MOL) during the dominance of Omicron SARS-CoV-2 lineage is urgently needed since the available data relates to the period of circulation of other viral variants. Therefore, this study assessed the efficacy of MOL in patients hospitalized for COVID-19 in a real-world clinical practice during the wave of Omicron infections. Methods. Among 11822 patients hospitalized after 1 March 2020 and included in the SARSTer national database, 590 were treated between 1 January and 31 April 2022, a period of dominance of the Omicron SARS-CoV-2 variant. MOL was administered to 203 patients, whereas 387 did not receive any antiviral regimen. Both groups were similar in terms of sex, BMI and age allowing for direct comparisons Results. Patients who did not receive antiviral therapy significantly more often required the use of Dexamethasone and Baricitinib. Treatment with MOL resulted in a statistically significant reduction in mortality during the 28-day follow-up (9.9 vs. 16.3%), which was particularly evident in the population of patients over 80 years of age treated in the first 5 days of the disease (14.6 vs. 35.2%). MOL therapy did not affect the frequency of the need for mechanical ventilation, but patients treated with MOL required oxygen supplementation less frequently than those without antivirals (31.7 vs. 49.2%). The time of hospitalization did not differ between groups. Conclusions. The use of molnupiravir in patients hospitalized for COVID-19 during the dominance of Omicron variant reduced mortality. This effect is particularly evident in patients over 80 years of age.

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Remdesivir-based therapy improved recovery of patients with COVID-19 in the SARSTer multicentre, real-world study

Cited by 17 publications

References 19 publications

Uso do Remdesivir no tratamento da Covid-19: uma revisão integrativa

Uso do Remdesivir no tratamento da Covid-19: uma revisão integrativa

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

Real-world experience with molnupiravir during the period of SARS-CoV-2 Omicron variant dominance

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