A retrospective real-world study of early short-course remdesivir in non-hospitalized COVID-19 patients at high risk for progression: low rate of hospitalization or death, regardless of immunocompetence status.
Por:
Ramos-Rincón JM, Pinargote-Celorio H, Llenas-García J, Moreno-Pérez O, González-Cuello I, Gonzalez-de-la-Aleja P, Martínez-López B, Reus S, García-López M, Rodríguez JC, Boix V and Merino E
Publicada:
10 oct 2023
Ahead of Print:
10 oct 2023
Resumen:
Introduction: The evidence for remdesivir therapy in immunocompromised patients is scarce. To evaluate remdesivir (RDV) effectiveness and safety in COVID-19 outpatients at high risk for progression in a real-world setting, we compare the outcome in immunocompromised (IC) patients with that in non-immunocompromised patients. Methods: Two hospitals conducted a retrospective study of all adult patients with mild-to-moderate SARS-CoV-2 infection at high risk for disease progression who were treated as outpatients with a 3-day course of RDV (1st January-30th September 2022). The primary effectiveness endpoint was a composite of any cause of hospitalization or death by day 30. A multiple logistic regression model was built to explore the association between immune status and clinical outcome, estimating adjusted odds ratios [aORs (95% CI)]. Results: We have included 211 patients, of which 57% were males, with a median age of 65 years (IQR 53-77), 70.1% were vaccinated (three or four doses), and 61.1% were IC. The median duration of symptoms before RDV treatment was 3 days (IQR 2-5). During follow-up, 14 (6.6%) patients were hospitalized, of which 6 (2.8%) were hospitalized for COVID-19 progression. No patient required mechanical ventilation, and two patients died (non-COVID-19-related). After accounting for potential confounders, only anti-CD20 treatment was associated with the composed outcome [aOR 5.35 (1.02-27.5, 95% CI)], whereas the immunocompetence status was not [aOR 1.94 (0.49-7.81, 95% CI)]. Conclusion: Early COVID-19 outpatient treatment with a 3-day course of remdesivir in vaccinated patients at high risk for disease progression during the Omicron surge had a good safety profile. It was associated with a low rate of all-cause hospitalization or death, regardless of immunocompetence status.
Filiaciones:
Ramos-Rincón JM:
Internal Medicine Department, Dr. Balmis General University Hospital-Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
Clinical Medicine Department, Miguel Hernández University, Elche, Spain
Pinargote-Celorio H:
Unit of Infectious Diseases Dr. Balmis General University Hospital-Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
:
Clinical Medicine Department, Miguel Hernández University, Elche, Spain
Internal Medicine Service Vega Baja Hospital-Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
Moreno-Pérez O:
Clinical Medicine Department, Miguel Hernández University, Elche, Spain
Endocrinology Department Dr. Balmis General University Hospital-Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
:
Internal Medicine Service Vega Baja Hospital-Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
Gonzalez-de-la-Aleja P:
Unit of Infectious Diseases Dr. Balmis General University Hospital-Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
Martínez-López B:
Internal Medicine Service Vega Baja Hospital-Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
Reus S:
Clinical Medicine Department, Miguel Hernández University, Elche, Spain
Unit of Infectious Diseases Dr. Balmis General University Hospital-Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
:
Internal Medicine Service Vega Baja Hospital-Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
Rodríguez JC:
Clinical Medicine Department, Miguel Hernández University, Elche, Spain
Microbiology Service Dr. Balmis General University Hospital-Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
Boix V:
Clinical Medicine Department, Miguel Hernández University, Elche, Spain
Unit of Infectious Diseases Dr. Balmis General University Hospital-Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
Merino E:
Clinical Medicine Department, Miguel Hernández University, Elche, Spain
Unit of Infectious Diseases Dr. Balmis General University Hospital-Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
Green Published, gold
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