Therapeutic Efficacy and Outcomes of Remdesivir versus Remdesivir with Tocilizumab in Severe SARS-CoV-2 Infection

Abstract

The infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) generated many challenges to find an effective drug combination for hospitalized patients with severe forms of coronavirus disease 2019 (COVID-19) pneumonia. We conducted a retrospective cohort study, including 182 patients with severe COVID-19 pneumonia hospitalized between March and October 2021 in a Pneumology Hospital from Cluj-Napoca, Romania. Among patients treated with standard of care, 100 patients received remdesivir (R group) and 82 patients received the combination of remdesivir plus tocilizumab (RT group). We compared the clinical outcomes, the inflammatory markers, superinfections, oxygen requirement, intensive care unit (ICU) admission and mortality rate before drug administration and 7 days after in R group and RT group. Borg score and oxygen support showed an improvement in the R group (p < 0.005). Neutrophiles, C-reactive protein (CRP) and serum ferritin levels decreased significantly in RT group but with a higher rate of superinfection in this group. ICU admission and death did not differ significantly between groups. The combination of remdesivir plus tocilizumab led to a significantly improvement in the inflammatory markers and a decrease in the oxygen requirement. Although the superinfection rate was higher in RT group than in R group, no significant difference was found in the ICU admission and mortality rate between the groups.

GPT (Generative Pre-Trained Transformer)— A Comprehensive Review on Enabling Technologies, Potential Applications, Emerging Challenges, and Future Directions

“…• Personalized medicine: The COVID-19 pandemic has highlighted that not all body systems are clinically similar. For instance, during the pandemic, medicines like Remdesivir and Tocilizumab have been effective for one category of patients but do not affect another category of patients with similar clinical metrics, as they progress from a mild or moderate level of infection to a severe stage [95]. This highlights the need for personalized medicine in today's world.…”

Aprotinin—Drug against Respiratory Diseases

“…Several drug combinations for the treatment of COVID-19 patients were studied, such as FVP + hydroxychloroquine (HCQ) [ 276 , 277 ], FVP + methylprednisolone [ 278 , 279 ], FVP + lopinavir-ritonavir [ 280 ], FVP + camostat + ciclesonide [ 281 ], RDV + Olumiant ® [ 282 ], RDV + Tocilizumab [ 283 , 284 , 285 ], RDV + LY-CoV555 [ 286 ], RDV + IFN β-1a [ 287 ], RDV + dexamethasone [ 288 ], MOV + IFN-α (in Calu-3 cells) [ 289 ], and MOV + FVP (in hamster infection model) [ 290 ]. Of the drug combinations listed above, only the combination of RDV + Olumiant ® was found to be more effective than RDV monotherapy [ 291 ].…”