Remdesivir May Benefit Adults Early in COVID-19 Course

Real-world data support the use of remdesivir for hospitalized COVID-19 patients receiving no oxygen or low-flow oxygen
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FRIDAY, Jan. 28, 2022 (HealthDay News) -- Hospitalized COVID-19 patients receiving no oxygen or low-flow oxygen were more likely to achieve clinical improvement within 28 days if they were treated with remdesivir, according to a study published online Dec. 15 in Clinical Infectious Diseases.

Brian T. Garibaldi, M.D., from Johns Hopkins University in Baltimore, and colleagues retrospectively assessed the effectiveness of remdesivir for treatment of COVID-19. The analysis included 18,328 patients hospitalized with confirmed COVID-19 (Feb. 23, 2020, through Feb. 11, 2021) who received at least one dose of remdesivir and matched COVID-19 patients not receiving remdesivir.

The researchers found that 74 percent of remdesivir-treated patients had clinical improvement within 28 days (median time of seven days) versus 68.3 percent of control patients (median time of nine days). Those treated with remdesivir were significantly more likely to achieve clinical improvement by 28 days (adjusted hazard ratio [aHR], 1.19; 95 percent confidence interval [CI], 1.16 to 1.22). Clinical improvement was more likely to be achieved by 28 days for remdesivir-treated patients on no oxygen (aHR, 1.30; 95 percent CI, 1.22 to 1.38) or low-flow oxygen (aHR, 1.23; 95 percent CI, 1.19 to 1.27). For overall mortality, there was no significant impact observed (aHR, 1.02; 95 percent CI, 0.97 to 1.08). However, remdesivir recipients on low-flow oxygen were significantly less likely to die than controls (aHR, 0.85 [95 percent CI, 0.77 to 0.92]; 28-day mortality, 8.4 percent for remdesivir patients versus 12.5 percent for controls).

"We observed that remdesivir is best used as early as possible, before the patient progresses to requiring high levels of oxygen or intubation and mechanical ventilation," Garibaldi said in a statement. "Most patients who need that kind of advanced respiratory support are likely past the point where antiviral therapies like remdesivir would be effective."

Several authors disclosed financial ties to pharmaceutical companies, including Gilead, the manufacturer of remdesivir.

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