Role of Remdesivir in Covid-19 Patients: A Study from the Capital City of Pakistan

Abstract

Background Coronavirus disease 2019, caused by SARS-COVID-19 has emerged as a pandemic. It usually causes severe respiratory disease. Characteristically it undergoes genetic variability and newer strains emerge as a result of genetic mutations or environmental factors. It makes it difficult to be treated. We used remdesivir in our hospital to treat covid-19 patients. The aim of our study was to evaluate the role of remdesivir in COVID-19 patients. Patients and Methods We conducted a descriptive cross sectional study on the patients admitted in the department of Medicine, Capital hospital, Islamabad, Pakistan from November 2020 to October 2021. All patients aged 14 years and above were included. Both SARS-CoV-2 positive patients by molecular biology and COVID suspected cases, selected on the basis of low oxygen saturation, deranged inflammatory markers, positive contact history and radiological findings with negative COVID19 PCR testing were included in the study. The data was compiled using Microsoft Excel and later was analyzed on SPSS version 24. Results Among 669 patients, 375 (56.1 %) were males and 294 (43.9%) were females. Median age of patients was 58.2 years. 349 (52.2%) were COVID PCR positive and 320 (47.8%) were PCR negative. Out of 669 patients 573 (85.7%) were discharged and 96 (14.3%) expired. Inflammatory markers before and after the treatment were measured with overall significant decrease (P-value 0.000) after treatment. Patients were divided into two groups, remdesivir given (n=436) and remdesivir not given (n=233). Hospital stay was of shorter duration among 249(57.6%) in remdesivir given group than in remdesivir not given group 183(42.4%). While evaluating outcome 370(64.6%) patients were discharged and 66(68.7%) expired in remdesivir given group and 203 (35.4%) patients were discharged and 30 (31.3%) expired in second group. Lactic dehydrogenase (LDH) level was raised (>480 U/L) in 378(68.5%) patients before taking remdesivir and was raised only in 209(47.9%) patients after taking remdesivir (P-0.027). Conclusion Our study revealed that Hospital stay was shorter (P-value 0.000) in remdesivir given group. There was no significant effect of remdesivir on patient’s outcome and mortality (P-value 0.250). Only Lactic dehydrogenase was significantly decreased (p-value 0.027) in remdesivir given group. Key words COVID-19, Remdesivir, outcome, Inflammatory markers