Early Use of Remdesivir in Patients Hospitalized With COVID-19 Improves Clinical Outcomes: A Retrospective Observational Study

Link to article at PubMed

Infect Dis Clin Pract (Baltim Md). 2021 Sep;29(5):e282-e286. doi: 10.1097/IPC.0000000000001023. Epub 2021 Apr 15.

ABSTRACT

BACKGROUND: Remdesivir treatment, like most antiviral drugs, is likely to be most effective when used early in the course of coronavirus disease 2019 (COVID-19). Optimal timing of remdesivir for the treatment of COVID-19 remains unclear.

OBJECTIVES: The aim of this study was to determine whether early treatment with remdesivir improves clinical outcomes: length of stay, need for mechanical ventilation, and death.

METHODS: We conducted a retrospective observational study of patients hospitalized with COVID-19 who received remdesivir therapy within 10 days of symptom onset at a large health system in Georgia, United States.

RESULTS: We identified a total of 475 patients. Initiation of therapy 3 days or less from first positive SARS-CoV-2 improved length of stay (15.7 days) compared with those started on therapy more than 3 days after a positive test (19.3 days) (P = 0.03). In the ≤3 day group, further reduction in length of stay was seen in those with lower oxygen requirement at baseline (P < 0.0001). Length of stay was lower in the ≤3 day group both with and without the use of corticosteroids (P = 0.0003). The odds of requiring mechanical ventilation were higher for the >3 day group compared with the ≤3 day group (odds ratio, 1.5; 95% confidence interval, 0.8-2.7), and the odds of death were higher for the >3 day group versus the ≤3 day group (odds ratio, 1.74; 95% confidence interval, 0.9-3.2).

CONCLUSIONS: Our data show that early treatment with remdesivir in patients hospitalized with COVID-19 shortened length of stay.

PMID:34539162 | PMC:PMC8436815 | DOI:10.1097/IPC.0000000000001023

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