Remdesivir and Mortality in Patients with COVID-19.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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
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.
Diaz, George A; Christensen, Alyssa B; Pusch, Tobias; Goulet, Delaney; Chang, Shu-Ching; Grunkemeier, Gary L; McKelvey, Paul A; Robicsek, Ari; French, Tom; Parsons, Guilford T; Doherty, Glenn; Laurenson, Charles; Roper, Ryan; Hadlock, Jennifer; Cover, Cameron J; Footer, Brent; Robinson, Philip; Micikas, Mary; Marfori, Jennifer E; Cronenweth, Charlotte; Mukkamala, Yogavedya; Mackiewicz, Jamie; Rai, Ekra; Matson, Martha Dickinson; Davila, Jodie; Rueda, Justin; Tipton, Reda; Algren, Heather; Ward, Brittney C; Malkoski, Stephen; Gluckman, Tyler; Tallman, Gregory B; Arguinchona, Henry; Hammond, Terese C; Standaert, Steven; Christensen, Joshua; Echaiz, Jose F; Choi, Robert; McClung, Daniel; Pacifico, Albert; Fee, Martin; Sarafian, Farjad; Berrington, William R; and Goldman, Jason D, "Remdesivir and Mortality in Patients with COVID-19." (2021). Articles, Abstracts, and Reports. 5178.