Temporal Improvements in COVID-19 Outcomes for Hospitalized Adults: A Post Hoc Observational Study of Remdesivir Group Participants in the Adaptive COVID-19 Treatment Trial

Abstract

Background:The COVID-19 standard of care (SOC) evolved rapidly during 2020 and 2021, but its cumulative effect over time is unclear.Objective: To evaluate whether recovery and mortality improved as SOC evolved, using data from ACTT (Adaptive .Design: ACTT is a series of phase 3, randomized, double-blind, placebo-controlled trials that evaluated COVID-19 therapeutics from February 2020 through May 2021. ACTT-1 compared remdesivir plus SOC to placebo plus SOC, and in ACTT-2 and ACTT-3, remdesivir plus SOC was the control group. This post hoc analysis compared recovery and mortality between these comparable sequential cohorts of patients who received remdesivir plus SOC, adjusting for baseline characteristics with propensity score weighting. The analysis was repeated for participants in ACTT-3 and ACTT-4 who received remdesivir plus dexamethasone plus SOC. Trends in SOC that could explain outcome improvements were analyzed. (ClinicalTrials.gov: NCT04280705 [ACTT-1], NCT04401579 [ACTT-2], NCT04492475 [ACTT-3], and NCT04640168 [ACTT-4])Setting: 94 hospitals in 10 countries (86% U.S. participants).

Toward an Improved Electrocatalytic Determination of Immunomodulator COVID Medication Baricitinib Using Multiwalled Carbon Nanotube Nickel Hybrid

“…Our findings revealed that none of these substances exhibited any electrochemical activity. Furthermore, we also investigated the impact of 60-fold concentrations of inorganic ions such as Ca 2+ , Zn 2+ , Na + , Fe 3+ , K + , Mg 2+ , NO 3− , SO 4 2− , and Cl − , as well as substances like Mg stearate, Mannitol, microcrystalline cellulose, ferric oxide, titanium dioxide, poly(vinyl alcohol), lecithin, polyethylene glycol, and talc. Surprisingly, none of these substances had a discernible effect on the anodic current associated with BARI.…”

“…Its approval by the U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH) represents a significant milestone in the ongoing battle against the pandemic. 3,4 In November 2020, the FDA granted emergency use authorization (EUA) for the utilization of Baricitinib (BARI) ([1-ethylsulfonyl-3-[4-(7H-pyrrolo [2,3-d]pyrimidin-4yl)pyrazol-1-yl]azetidin-3-yl]acetonitrile, depicted in Figure S1) in conjunction with remdesivir for the treatment of hospitalized COVID-19 patients. 5 This decision was based on promising clinical trial data, which demonstrated that the combination therapy significantly reduced recovery time and improved clinical outcomes compared to remdesivir alone.…”

“…In patients with Coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a severe inflammatory response similar to cytokine release syndrome has been associated with acute respiratory distress syndrome and organ impairment. , Baricitinib, identified as a Janus kinase (JAK) inhibitor, has emerged as a potential therapeutic approach for COVID-19. Its approval by the U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH) represents a significant milestone in the ongoing battle against the pandemic. , In November 2020, the FDA granted emergency use authorization (EUA) for the utilization of Baricitinib (BARI) ([1-ethylsulfonyl-3-[4-(7H-pyrrolo­[2,3- d ]­pyrimidin-4-yl)­pyrazol-1-yl]­azetidin-3-yl]­acetonitrile, depicted in Figure S1) in conjunction with remdesivir for the treatment of hospitalized COVID-19 patients . This decision was based on promising clinical trial data, which demonstrated that the combination therapy significantly reduced recovery time and improved clinical outcomes compared to remdesivir alone .…”

Drug treatment of COVID-19 infection

“…Nevertheless, in an incredibly short period of time, scientific research advances on prevention and treatment of SARS-CoV-2 infection were developed. The widespread rollout of SARS-CoV-2 vaccines and improvement in the standard of care in treatment has dramatically reduced morbidity and mortality of COVID-19 [ 2 , 3 ].…”

Effect and safety of mesenchymal stem cells for patients with COVID‐19: Systematic review and meta‐analysis with trial sequential analysis

“…1 The disease of patients who are infected with SARS-CoV-2 progresses rapidly, and affected patients may get through acute respiratory distress syndrome (ARDS), 2 respiratory failure, 3 coagulopathies, 4 multiorgan dysfunction (MOD), 5 and even death within a short time. 6 To date, despite numerous kinds of treatments, such as Paxlovid, 7 Remdesivir, 8 dexamethasone, 9 convalescent plasma, 10 and vaccine, 11 have been tested among COVID-19 patients, the mortality among hospitalized patients remains high, especially among patients who admitted to the intensive care unit (ICU), with rates ranging from 35% to 66%. 3,[12][13][14][15] Because of the universal concerns about the virus and the disturbing nature of its accelerated spread, finding effective treatments has become a priority.…”