tetano
Editor, Senior Moderator
Influenza Other Respir Viruses
. 2023 May 17;17(5):e13136.
doi: 10.1111/irv.13136. eCollection 2023 May. Clinical outcomes of COVID-19 treated with remdesivir across the continuum of care
Christina G Rivera[SUP] 1 [/SUP], Supavit Chesdachai[SUP] 2 [/SUP], Evan W Draper[SUP] 1 [/SUP], Richard F Arndt[SUP] 3 [/SUP], Kristin C Mara[SUP] 4 [/SUP], Maria Gonzalez Suarez[SUP] 5 [/SUP], Raymund R Razonable[SUP] 2 [/SUP]
Affiliations
Introduction: During the early phase of the coronavirus disease 2019 (COVID-19), remdesivir was only approved for hospitalized patients. Our institution developed hospital-based, outpatient infusion centers for selected hospitalized patients with COVID-19 who had clinical improvement to allow for early dismissal. The outcomes of patients who transitioned to complete remdesivir in the outpatient setting were examined.
Methods: Retrospective study of all hospitalized adult patients with COVID-19 who received at least one dose of remdesivir from November 6, 2020, to November 5, 2021, at one of the Mayo Clinic hospitals.
Results: Among 3029 hospitalized patients who received treatment with remdesivir for COVID-19, the majority (89.5%) completed the recommended 5-day course. Among them, 2169 (80%) patients completed treatment during hospitalization, whereas 542 (20.0%) patients were dismissed to complete remdesivir in outpatient infusion centers. Patients who completed the treatment in the outpatient setting had lower odds of death within 28 days (aOR 0.14, 95% CI 0.06-0.32, p < 0.001). However, their rate of subsequent hospital encounters within 30 days was higher (aHR 1.88, 95% CI 1.27-2.79, p = 0.002). Among patients treated with remdesivir only in the inpatient setting, the adjusted odds of death within 28 days were significantly higher among those who did not complete the 5-day course of remdesivir (aOR 2.07, 95% CI 1.45-2.95, p < 0.001).
Conclusions: This study describes the clinical outcomes of a strategy of transitioning remdesivir therapy from inpatient to outpatient among selected patients. Mortality was lower among patients who completed the 5-day course of remdesivir.
Keywords: COVID‐19; SARS‐2‐CoV; hospitalization; remdesivir.
. 2023 May 17;17(5):e13136.
doi: 10.1111/irv.13136. eCollection 2023 May. Clinical outcomes of COVID-19 treated with remdesivir across the continuum of care
Christina G Rivera[SUP] 1 [/SUP], Supavit Chesdachai[SUP] 2 [/SUP], Evan W Draper[SUP] 1 [/SUP], Richard F Arndt[SUP] 3 [/SUP], Kristin C Mara[SUP] 4 [/SUP], Maria Gonzalez Suarez[SUP] 5 [/SUP], Raymund R Razonable[SUP] 2 [/SUP]
Affiliations
- PMID: 37228805
- PMCID: PMC10205088
- DOI: 10.1111/irv.13136
Introduction: During the early phase of the coronavirus disease 2019 (COVID-19), remdesivir was only approved for hospitalized patients. Our institution developed hospital-based, outpatient infusion centers for selected hospitalized patients with COVID-19 who had clinical improvement to allow for early dismissal. The outcomes of patients who transitioned to complete remdesivir in the outpatient setting were examined.
Methods: Retrospective study of all hospitalized adult patients with COVID-19 who received at least one dose of remdesivir from November 6, 2020, to November 5, 2021, at one of the Mayo Clinic hospitals.
Results: Among 3029 hospitalized patients who received treatment with remdesivir for COVID-19, the majority (89.5%) completed the recommended 5-day course. Among them, 2169 (80%) patients completed treatment during hospitalization, whereas 542 (20.0%) patients were dismissed to complete remdesivir in outpatient infusion centers. Patients who completed the treatment in the outpatient setting had lower odds of death within 28 days (aOR 0.14, 95% CI 0.06-0.32, p < 0.001). However, their rate of subsequent hospital encounters within 30 days was higher (aHR 1.88, 95% CI 1.27-2.79, p = 0.002). Among patients treated with remdesivir only in the inpatient setting, the adjusted odds of death within 28 days were significantly higher among those who did not complete the 5-day course of remdesivir (aOR 2.07, 95% CI 1.45-2.95, p < 0.001).
Conclusions: This study describes the clinical outcomes of a strategy of transitioning remdesivir therapy from inpatient to outpatient among selected patients. Mortality was lower among patients who completed the 5-day course of remdesivir.
Keywords: COVID‐19; SARS‐2‐CoV; hospitalization; remdesivir.