Background and importance Severe SARS-CoV-2 pneumonia (COVID-19) is causing an increasing number of deaths worldwide because no effective treatment is currently available. Remdesivir has shown in vitro activity against coronaviruses and is being used as an antiviral treatment for COVID-19.
Aim and objectives To evaluate the use and results of remdesivir treatment in hospital settings.
Material and methods A retrospective study was conducted at an 800-bed hospital and involved patients with COVID-19, between March 2020 and June 2021, aged over 18 years, and undergoing treatment with remdisivir. We extracted information from the hospital files, Soarian and Hosix VB and the database was analysed using Excel 5.0, using descriptive and inferential statistics.
Results The 199 patients enrolled in the study were mainly men, staying in medical wards and intensive care units (ICU) and with an age average of 65 years. Of the 84% patients that finished the treatment with remdesivir, 157 completed a 5-day course and 11 patients completed a 10-day course. Of the 16% patients that interrupted the treatment, all due to adverse events, most were in medical wards and, of these, 67% were discharged and 25% died. In those staying in ICU that suffered adverse events, 20% were discharged and 40% died. Overall, the main adverse events were hypertransaminasemia, bradycardia and acute kidney injury. All patients with hypertransaminasemia improved, but half of the patients that stopped the treatment with remdesivir due to bradycardia died. Of all the patients, 77% were discharged, but 20% died. Of the group of patients who died, 77% were in ICU and 21% had adverse events with remdesivir. We found a significant relationship between ICU stay and patients who completed the treatment (p=0.022, p<0.05) and also with age above 75 years (p=0.027, p<0.05).
Conclusion and relevance As expected, most of the patients who died were in ICU and 16% suffered adverse events. Nonetheless, our data suggest that remdesivir can benefit non-criticallly ill patients with COVID-19, where clinical improvement was observed in 77% of the patients with discharged. Adverse events were less frequent, but when they occurred, they was mainly hypertransaminasemia and bradycardia. It is expected that ongoing randomised controlled trials will clarify its real efficacy and safety, and who and when to treat.
Conflict of interest No conflict of interest
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