Remdesivir: Effectiveness and safety in hospitalized patients with COVID-19 (ReEs-COVID19) - Analysis of data from daily practice

Abstract

Background Remdesivir was the first antiviral approved for COVID-19. We investigated its patterns of use, effectiveness and safety in clinical practice in Greece. Methods Retrospective observational study of hospitalized adults who received remdesivir for COVID-19 between 09/2020–02/2021. Main endpoints were time to recovery (hospital discharge within 30 days from admission) and safety. The “early” (remdesivir initiation within 2 days) and the “deferred” (remdesivir initiation > 2days after admission) groups were compared. Results 1004 patients (60.6% male, mean age 61 years, 74.3% with severe disease, 70.9% with ≥1 comorbidities) were included, 75.9% of them on a 5-days regimen and 86.8% in the early group. Among those with baseline mild/moderate disease, median (95% CI) time to recovery was 8 (7–9) and 12 (11–14) days for the early and deferred group respectively (p < 0.001). Corresponding estimates for those with severe disease: 10 (9–10) and 13 (11–15) days, respectively (p = 0.028). After remdesivir initiation, increased serum transaminases and acute kidney injury were observed in 6.9% and 2.1%, respectively. Nine (0.9%) patients discontinued treatment due to adverse events. Conclusions Effectiveness of remdesivir was higher when taken within the first 2-days of admission regardless of disease severity. Remdesivir safety profile was similar to that described in clinical trials and other real-world cohorts.