comparative effectiveness study A study covering SARS-CoV-2 variants of concern (VOC) found that the antiviral drug remdesivir (Veklury) significantly reduced in-hospital COVID-19 mortality in adults receiving supplemental oxygen upon admission.
The study, led by researchers at remdesivir manufacturer Gilead Sciences, was published today in Infectious Diseases Open Forum.
team Compared 67,582 hospitalized COVID-19 patients receiving low-flow oxygen (LFO), 34,857 patients receiving high-flow oxygen/non-invasive ventilation (HFO/NIV), and 4,164 invasive mechanical ventilation receiving remdesivir / Patients on extracorporeal membrane oxygenation (IMV/ECMO) and control patients between December 2020 and April 2022. Take at least one dose of remdesivir within 2 days of hospitalization.
The study authors noted that World Health Organization guidelines conditionally recommend remdesivir for use in patients with severe, but not critical, COVID-19. “The lack of recommendations for the use of remdesivir in critically ill patients may reflect lower efficacy or an inability to detect beneficial effects because clinical trials were not designed or powered to detect differences in remdesivir efficacy in subgroups based on baseline COVID-19 severity ,” they wrote.
Drug appears to protect against multiple variants
During the VOC, 5,853 remdesivir recipients (16.8%) and 6,770 controls (19.4%) died before 14 days. By day 28, 9,009 remdesivir-treated people (25.8%) and 9,853 controls (28.3%) had died.
In the United States, about one in two patients requiring invasive ventilation has died since the start of the pandemic.
Among remdesivir recipients, the response rate was 14 days (LFO, 6.4% vs 8.8%; HFO/NIV, 16.8% vs 19.4%; IMV/ECMO, 27.8% vs 35.3%) and 28 days (LFO, 9.8% vs 12.3%; HFO/NIV, 25.8% vs 28.3%; IMV/ECMO, 41.4% vs 50.6%).
After adjustment, remdesivir significantly reduced in-hospital death at 14 days (LFO adjusted hazard ratio (aHR), 0.72; HFO/NIV aHR, 0.83; IMV/ECMO aHR, 0.73) and 28 days (LFO aHR, 0.79) Rate. ; HFO/NIV aHR, 0.88; IMV/ECMO aHR, 0.74) versus no remdesivir.
“In the United States, approximately one in two patients requiring invasive ventilation has died since the beginning of the pandemic,” the authors wrote. Remdesivir should be given immediately to all hospitalized COVID-19 patients, he said. “Continuing to evaluate treatment options for treating patients throughout the period of COVID-19 disease and VOCs remains critical.”