Clinical outcomes by supplemental oxygen use in remdesivir-treated, hospitalised adults with COVID-19 - 15/10/23
, Pallav L. Shah b, c, d , Lambert Assoumou e , Casper Rokx f , Nathalie De Castro g , Ameet Bakhai h , Alex Soriano Viladomiu i , Lourdes Mateu j , Carlos Lumbreras k , Vicente Estrada l , Adrian Curran m , Pierre-Olivier Sellier n , Annie Duffy o , Carl Fletcher o , Essy Mozaffari p , Richard Haubrich p , Paul Hodgkins p , Anton Pozniak c , Francois Raffi q
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Highlights |
• | Real-world study of hospitalised COVID-19 patients treated with remdesivir. |
• | Higher mortality and longer hospitalisation in HFO compared to LFO and NSO groups. |
• | Early initiation (upon admission) of remdesivir has mortality benefit. |
• | Remdesivir use and outcomes differed by country. |
Abstract |
Background |
Clinical trials show different effects of remdesivir on clinical outcomes relative to COVID-19 severity at hospital admission; in Europe, there are few real-world data.
Methods |
A multicentre, multinational retrospective cohort study in adult patients hospitalised with PCR-confirmed COVID-19 was conducted to understand remdesivir clinical use in different countries and to describe outcomes for patients receiving remdesivir stratified by oxygen use. Primary endpoints were all-cause mortality at day 28 and hospitalisation duration. Patients were categorised by baseline disease severity: no supplemental oxygen (NSO); low flow oxygen ≤ 6 litres (l)/minute (LFO); high flow oxygen > 6 l/minute (HFO).
Results |
Four hundred and forty-eight (448) patients (72 [16.1%] HFO; 295 [65.8%] LFO; 81 (18.1%] NSO) were included; median age was 65 years and 64% were male. Mortality was higher in patients on HFO (rate 23.6%) compared to LFO (10.2%; p = 0.001) or NSO (6.2%; p = 0.002). Duration of hospitalisation was longer in patients on HFO (13 days) compared to LFO (9 days; p = 0.003) and NSO (9 days; p = 0.021). Patients who initiated remdesivir ≥ 2 days compared to within a day of hospitalisation had a 4.2 times higher risk of death, irrespective of age, sex, comorbidities, and oxygen support at baseline. Requirement for mechanical ventilation/ECMO and readmission within 28 days of discharge was similar across groups. Remdesivir use and outcomes differed by country.
Conclusions |
A higher mortality rate and duration of hospitalisation was seen in remdesivir-treated COVID-19 patients on HFO compared to LFO and NSO. Initiation of remdesivir upon admission as opposed to delayed initiation has a mortality benefit.
Clinical Trials Registration: NCT04847622.
Le texte complet de cet article est disponible en PDF.Keywords : COVID-19, Remdesivir, Supplemental oxygen, Outcome, Mortality
Plan
Vol 53 - N° 7
Article 104760- octobre 2023 Retour au numéro
Article précédent
- Groundbreaking outpatient activity in medical entomology in France: An eight-year experience in a french university hospital
- Jacques Sevestre, Pierre Marty, Thomas Hubiche, Christelle Pomares, Pascal Delaunay
- Simplified antibiotic guidelines in urology are associated with decreased multidrug-resistant Enterobacterales
- Pierre-Marie Roger, Sylvaine Bastian, Sébastien Breurec, Marion Saliège, Pascal Blanchet, Laurent Brureau
Bienvenue sur EM-consulte, la référence des professionnels de santé.