Remdesivir and Mortality in Patients with COVID-19.

Authors

George A Diaz, Division of Medicine, Section of Infectious Diseases, Providence Regional Medical Center Everett, Everett, WA, USAFollow
Alyssa B Christensen, Department of Pharmacy, Providence Oregon Region Shared Services, Portland, OR, USAFollow
Tobias Pusch, Department of Internal Medicine, Section of Infectious Diseases, Providence St. Vincent Medical Center, Portland, OR, USAFollow
Delaney Goulet, Division of Medicine, Section of Internal Medicine, Providence Regional Medical Center Everett, Everett, WA, USAFollow
Shu-Ching Chang, Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence St. Joseph Health, Portland, Oregon, USAFollow
Gary L Grunkemeier, Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence St. Joseph Health, Portland, Oregon, USAFollow
Paul A McKelvey, Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence St. Joseph Health, Portland, Oregon, USAFollow
Ari Robicsek, Department of Clinical Analytics, Providence St. Joseph Health, Renton, WA, USAFollow
Tom French, Department of Clinical Analytics, Providence St. Joseph Health, Renton, WA, USAFollow
Guilford T Parsons, Department of Clinical Analytics, Providence St. Joseph Health, Renton, WA, USAFollow
Glenn Doherty, Department of Clinical Analytics, Providence St. Joseph Health, Renton, WA, USAFollow
Charles Laurenson, Department of Clinical Analytics, Providence St. Joseph Health, Renton, WA, USAFollow
Ryan Roper, Institute for Systems Biology, Seattle, WA, USA
Jennifer Hadlock, Institute for Systems Biology, Seattle, WA, USA
Cameron J Cover, Department of Internal Medicine, Section of Infectious Diseases, Providence St. Vincent Medical Center, Portland, OR, USAFollow
Brent Footer, Department of Pharmacy, Providence Oregon Region Shared Services, Portland, OR, USAFollow
Philip Robinson, Department of Hospital Medicine, Division of Infectious Diseases, Hoag Memorial Hospital Presbyterian, Newport Beach, CA USA
Mary Micikas, Division of Infectious Diseases, Swedish Medical Center, Seattle, WA, USA, Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USAFollow
Jennifer E Marfori, Department of Internal Medicine, Section of Infectious Diseases, Providence St. Vincent Medical Center, Portland, OR, USAFollow
Charlotte Cronenweth
Yogavedya Mukkamala
Jamie Mackiewicz
Ekra Rai
Martha Dickinson Matson
Jodie Davila, Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USAFollow
Justin Rueda, Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USA
Reda Tipton, Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USAFollow
Heather Algren, Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USAFollow
Brittney C Ward
Stephen Malkoski, Sound Critical Care, Sacred Heart Medical Center, Spokane, WA, USAFollow
Tyler Gluckman, Department of Cardiology, Providence St. Vincent Medical Center, Portland, OR, USAFollow
Gregory B TallmanFollow
Henry Arguinchona, Providence Sacred Heart Medical Center, Spokane, WA, USAFollow
Terese C Hammond, John Wayne Cancer Institute and Cancer Clinic, Providence St Johns Health Center, Santa Monica, CA, USAFollow
Steven Standaert, Providence St. Peter's Hospital Olympia, WA, USAFollow
Joshua Christensen, Providence St Patrick Hospital, Missoula, MT, USAFollow
Jose F Echaiz, Infectious Diseases, Kadlec Regional Medical Center, Richland, WA, USAFollow
Robert Choi, Division of Medicine, Section of Infectious Diseases, Providence Regional Medical Center Everett, Everett, WA, USAFollow
Daniel McClung, Division of Medicine, Section of Infectious Diseases, Providence Regional Medical Center Everett, Everett, WA, USAFollow
Albert Pacifico, Division of Medicine, Section of Infectious Diseases, Providence Regional Medical Center Everett, Everett, WA, USAFollow
Martin Fee, Department of Hospital Medicine, Division of Infectious Diseases, Hoag Memorial Hospital Presbyterian, Newport Beach, CA USAFollow
Farjad Sarafian, Department of Hospital Medicine, Division of Infectious Diseases, Hoag Memorial Hospital Presbyterian, Newport Beach, CA USA
William R Berrington, Division of Infectious Diseases, Swedish Medical Center, Seattle, WA, USA, Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USAFollow
Jason D Goldman, Division of Infectious Diseases, Swedish Medical Center, Seattle, WA, USA, Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USAFollow

Document Type

Article

Publication Date

8-19-2021

Publication Title

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Keywords

renton; system; oregon; portland; psvmc; washington; everett; prmc; cards; cards publication; isb; hoag; newport; california; seatt; e; spokane; swedish; pshmc; krmc; kadlec; montana; missoula; sph; olympia; santa monica; jwci; sjci; system; covid-19

Abstract

BACKGROUND: The impact of remdesivir (RDV) on COVID-19 mortality is controversial, and the mortality effect in sub-groups of baseline disease severity has been incompletely explored. The purpose of this study was to assess the association of RDV with mortality in patients with COVID-19.

METHODS: In this retrospective cohort study we compared persons receiving RDV to persons receiving best supportive care (BSC). Patients hospitalized between 2/28/20 - 5/28/20 with laboratory confirmed SARS-CoV-2 infection were included when they developed COVID-19 pneumonia on chest radiography, and hypoxia requiring supplemental oxygen or SpO2 ≤ 94% on room air. The primary outcome was overall survival assessed with time-dependent Cox proportional-hazards regression and multivariable adjustment, including calendar time, baseline patient characteristics, corticosteroid use and effects for hospital.

RESULTS: 1,138 patients were enrolled including 286 who received RDV, and 852 treated with BSC, 400 of whom received hydroxychloroquine. Corticosteroids were used in 20.4% of the cohort (12.6% in RDV and 23% in BSC). In persons receiving RDV compared to those receiving BSC the HR (95%CI) for death was 0.46 (0.31 - 0.69) in the univariate model, p

CONCLUSION: Treatment with RDV was associated with lower mortality compared to BSC. These findings remain the same in the subgroup with baseline use of low-flow oxygen.

Department

Infectious Diseases

Department

Pharmacy

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