Remdesivir Reduces Mortality in Hemato-Oncology Patients with COVID-19

Abstract

Remdesivir is the first agent with proven clinical efficacy against coronavirus disease 2019 (COVID-19); however, its benefit is associated with early use, and its efficacy has been poorly studied in patients with hemato-oncological diseases, who have an increased risk of a severe course of infection. This study aimed to assess the effects of remdesivir on mortality, mechanical ventilation, and the duration of hospitalization in both the general population and in patients with hemato-oncological diseases. Materials and Methods: Longitudinal data for 4287 patients with confirmed COVID-19 were analyzed, including a subset of 200 individuals with hemato-oncological diseases. In total, 1285 (30.0%) patients received remdesivir, while the remaining patients were treated with other methods. Survival statistics for the 14-and 30-day observation time points were calculated using non-parametric and multivariate Cox models. Results: Mortality for the 14-and 30-day observation time points was notably lower among patients receiving remdesivir (7.2% vs 11.6%, p < 0.001 and 12.7% vs 16.0, p = 0.005, respectively); however, in multivariate models adjusted for age, sex, lung involvement, and lactate dehydrogenase and interleukin-6 levels, the administration of remdesivir did not reduce patient mortality at either the 14-day or 30-day time points. Among patients with haemato-oncological disease, significant survival benefit was observed at 14 and 30 days for patients treated with remdesivir (11.3% vs.16.7% and 24.2% vs 26.1%, respectively; p < 0.001). A favorable effect of remdesivir was also noted for the 14-day time point in multivariate survival analysis (HR:4.03 [95% confidence interval:1.37-11.88]; p = 0.01). Conclusion: Remdesivir significantly reduced the early mortality rate in COVID-19 patients with comorbid hemato-oncological disease, which emphasizes the need to administer this agent to immunosuppressed patients.

Effectiveness of the available early therapies in reducing severe COVID-19 in non-hospitalized patients with solid tumors on active treatment

“…Data on the impact of early therapies come from clinical trials where the groups of patients are pulled together and the subgroup of patients with solid cancers is not analyzed separately. A recent study assessed the effectiveness of remdesivir both in the general population and in 200 patients with hemato-oncological diseases ( 10 ), with a significant survival benefit observed at 14 and 30 days for the patients treated with remdesivir.…”

Use of Remdesivir in Patients Hospitalized for COVID-19 Pneumonia: Effect on the Hypoxic and Inflammatory State

“…At the time we are writing, most nations have declared concluding the emerging phase of the pandemic and it has been suggested that the disease will become endemic and will be characterized by a lower pathogenicity [ 21 ]; although the incidence of SARS-CoV-2-related pneumonia has dramatically fallen, given a large part of the world population vaccinated, still it represents a major threat in some specific populations, including nonvaccinated individuals, elderly, patients with chronic conditions and oncologic patients, particularly those with hemato-oncological disease [ 3 , 22 ]. Therefore, the search for effective drugs still remains crucial.…”

“…SARS-CoV-2-related pneumonia is associated with hypoxemic respiratory failure, the severity of which varies across different populations and through the different waves of the pandemic [ 2 ]. At this time, when the emergency phase has just passed, older age, chronic diseases and oncological conditions, particularly hematological, still represent a major risk factor for COVID-19-related severe respiratory failure and intensive care requirement [ 3 ]. Indeed, proper management of patients with COVID-19 includes best practices for supportive care of acute hypoxic respiratory failure; however, since the onset of the pandemic, intense research has been conducted in order to identify specific pharmacological treatments [ 4 ].…”

Artificial neural network based prediction of the lung tissue involvement as an independent in‐hospital mortality and mechanical ventilation risk factor in COVID‐19

“…In the advanced stages of COVID-19, cytokine storm is one of the primary features associated with unfavorable survival outcomes. [4][5][6][7] Pneumonia and respiratory failure remain key COVID-19 complications, regardless of the infecting variant. 8,9 Radiological imaging techniques, including computed tomography (CT), allow for a thorough investigation of the type and volume of lung tissue involved in COVID-19.…”

“…However, hospitalized patients have limited efficacy, often reducing the mortality risk only in selected subgroups or within—5–7 day time of symptom onset. In the advanced stages of COVID‐19, cytokine storm is one of the primary features associated with unfavorable survival outcomes 4–7 . Pneumonia and respiratory failure remain key COVID‐19 complications, regardless of the infecting variant 8,9 …”