tetano
Editor, Senior Moderator
J Med Virol
. 2022 Sep 23.
doi: 10.1002/jmv.28168. Online ahead of print.
Effectiveness of remdesivir with corticosteroids for COVID-19 patients in intensive care unit: a hospital-based observational study
Mariko Hanafusa[SUP] 1 [/SUP], Nobutoshi Nawa[SUP] 2 [/SUP], Yuki Goto[SUP] 1 [/SUP], Tomoki Kawahara[SUP] 1 [/SUP], Shigeru Miyamae[SUP] 3 [/SUP], Yutaka Ueki[SUP] 4 [/SUP], Nobuyuki Nosaka[SUP] 5 [/SUP], Kenji Wakabayashi[SUP] 5 [/SUP], Shuji Tohda[SUP] 6 [/SUP], Ukihide Tateishi[SUP] 7 [/SUP], Takeo Fujiwara[SUP] 1 [/SUP]
Affiliations
Abstract
Objectives: The effectiveness of remdesivir on survival in coronavirus disease 2019 (COVID-19), especially in cases treated in the intensive care unit (ICU), is controversial. We investigated the effectiveness of remdesivir with corticosteroids on the survival of COVID-19 patients in a real ICU clinical practice.
Methods: For laboratory-confirmed COVID-19 patients admitted to the ICU of a tertiary hospital in Tokyo (April 2020 - November 2021) and received corticosteroids, the effectiveness of remdesivir for survival, stratified by interval length (within 9 or 10+ days) were retrospectively analyzed using Cox regression model.
Results: A total of 168 patients were included: 35 with no remdesivir use (control), 96 with remdesivir use within 9 days, and 37 with remdesivir use with interval 10+ days. In-hospital mortality was 45.7%, 10.4%, and 16.2%, respectively. After adjusting for possible covariates including comorbidities, laboratory data, oxygen demand, or level of pneumonia, remdesivir use within 9 days from symptom onset reduced mortality risk (hazard ratio (HR) 0.10; 95% confidence interval (CI) 0.025 to 0.428) compared to control group. However, remdesivir use with interval 10+ days showed no significant association with mortality (HR: 0.42, 95% CI: 0.117-1.524).
Conclusions: Among COVID-19 patients who received corticosteroids in ICU, remdesivir use within 9 days from symptom onset was associated with reduced in-hospital mortality risk. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Intensive Care Units; mortality; pneumonia; remdesivir.
. 2022 Sep 23.
doi: 10.1002/jmv.28168. Online ahead of print.
Effectiveness of remdesivir with corticosteroids for COVID-19 patients in intensive care unit: a hospital-based observational study
Mariko Hanafusa[SUP] 1 [/SUP], Nobutoshi Nawa[SUP] 2 [/SUP], Yuki Goto[SUP] 1 [/SUP], Tomoki Kawahara[SUP] 1 [/SUP], Shigeru Miyamae[SUP] 3 [/SUP], Yutaka Ueki[SUP] 4 [/SUP], Nobuyuki Nosaka[SUP] 5 [/SUP], Kenji Wakabayashi[SUP] 5 [/SUP], Shuji Tohda[SUP] 6 [/SUP], Ukihide Tateishi[SUP] 7 [/SUP], Takeo Fujiwara[SUP] 1 [/SUP]
Affiliations
- PMID: 36148941
- DOI: 10.1002/jmv.28168
Abstract
Objectives: The effectiveness of remdesivir on survival in coronavirus disease 2019 (COVID-19), especially in cases treated in the intensive care unit (ICU), is controversial. We investigated the effectiveness of remdesivir with corticosteroids on the survival of COVID-19 patients in a real ICU clinical practice.
Methods: For laboratory-confirmed COVID-19 patients admitted to the ICU of a tertiary hospital in Tokyo (April 2020 - November 2021) and received corticosteroids, the effectiveness of remdesivir for survival, stratified by interval length (within 9 or 10+ days) were retrospectively analyzed using Cox regression model.
Results: A total of 168 patients were included: 35 with no remdesivir use (control), 96 with remdesivir use within 9 days, and 37 with remdesivir use with interval 10+ days. In-hospital mortality was 45.7%, 10.4%, and 16.2%, respectively. After adjusting for possible covariates including comorbidities, laboratory data, oxygen demand, or level of pneumonia, remdesivir use within 9 days from symptom onset reduced mortality risk (hazard ratio (HR) 0.10; 95% confidence interval (CI) 0.025 to 0.428) compared to control group. However, remdesivir use with interval 10+ days showed no significant association with mortality (HR: 0.42, 95% CI: 0.117-1.524).
Conclusions: Among COVID-19 patients who received corticosteroids in ICU, remdesivir use within 9 days from symptom onset was associated with reduced in-hospital mortality risk. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Intensive Care Units; mortality; pneumonia; remdesivir.