Κυριακή 25 Σεπτεμβρίου 2022

Effectiveness of remdesivir with corticosteroids for COVID‐19 patients in intensive care unit: a hospital‐based observational study

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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.

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