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Volume 2022, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: Treatment options for patients with critical Coronavirus Disease 2019 (COVID-19) are limited. This study aimed to describe the clinical characteristics and outcomes associated with remdesivir therapy in patients with COVID-19 who require non-invasive (NIV) ventilation or invasive mechanical ventilation (IMV).

Methods: Data were retrospectively extracted for adults with COVID-19 confirmed using polymerase chain reaction (PCR) between August 1, 2020 and January 28, 2021 who received ≥ 48 hours of remdesivir therapy while on NIV or IMV. Clinical improvement was defined as two-category improvement on an eight-point ordinal severity scale.

Results: A total of 133 individuals were included, of which 114 (85.7%) were on NIV and 19 (14.3%) were on IMV at the time of remdesivir initiation. The majority of the patients were males (62.4%), and the median age was 56 years. All the patients received concomitant dexamethasone therapy. Remdesivir treatment was commenced after a median of 7 days from onset of symptoms and was continued for a median of 5 days.

Clinical improvement within 28 days was achieved in 101 patients (75.9%); among which, 78.1% and 63.2% were subjected to baseline NIV and IMV, respectively. Among the 11 (8.3%) patients who died of any cause by day 28, 9 (7.9%) and 2 (10.5%) were subjected to baseline NIV and IMV, respectively. The most frequent adverse events were sinus bradycardia (21, 13.1%) and alanine transaminase increase (18, 11.3%). Almost all adverse events were classified as Grades 1–3.

Conclusion: The use of remdesivir in combination with systemic corticosteroids is associated with high recovery rates and low all-cause mortality in patients with COVID-19 pneumonia who require NIV or IMV. The results need confirmation from clinical trials of appropriate design and size.

© 2022 Alibrahim, Elmekaty, Elmekaty, Edbais, Alkhatib, Daghfal, Almaslamani, Omrani, licensee HBKU Press.
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2022-06-16
2024-11-13
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References

  1. Cevik M, Kuppalli K, Kindrachuk J, Peiris M. Virology, transmission, and pathogenesis of SARS-CoV-2. BMJ 2020;: 371: m3862.
     [Google Scholar]
  2. The WHO Rapid Evidence Appraisal for COVID-19 Therapies Working Group, Sterne JAC, Murthy S, Slutsky AS, Villar J, et al. Association between administration of systemic corticosteroids and mortality among critically ill patients with COVID-19: a meta-analysis. JAMA 2020;: 324: 1330–41.
     [Google Scholar]
  3. Tleyjeh IM, Kashour Z, Damlaj M, Riaz M, Tlayjeh H, Altannir M, et al. Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis. Clin Microbiol Infect 2021;: 27: 215–27.
     [Google Scholar]
  4. Aleissa MM, Silverman EA, Paredes Acosta LM, Nutt CT, Richterman A, Marty FM. New perspectives on antimicrobial agents: remdesivir treatment for COVID-19. Antimicrob Agents Chemother 2020;: 65: e01814–20.
     [Google Scholar]
  5. Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, et al. Remdesivir for the treatment of Covid-19—Final Report. N Engl J Med 2020;: 383: 1813–26.
     [Google Scholar]
  6. Bhimraj A, Morgan R, Shumaker A, Lavergne V, Baden L, Cheng V, et al. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. Version 4.3.0. Available at: https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/ [accessed 27 December 2021].
     [Google Scholar]
  7. National Institutes of Health COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Available at: https://www.covid19treatmentguidelines.nih.gov/ [accessed 27 December 2021].
     [Google Scholar]
  8. Australian National COVID-19 Clinical Evidence Taskforce. Australian guidelines for the clinical care of people with COVID-19. Version 40.1. Available at: https://app.magicapp.org/#/guideline/L4Q5An[accessed 27 December 2021].
     [Google Scholar]
  9. National Cancer Institute. Common Terminology Criteria for Adverse Events. Version 5.0. Available at: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm [accessed 27 December 2021].
     [Google Scholar]
  10. Omrani AS, Almaslamani MA, Daghfal J, Alattar RA, Elgara M, Shaar SH, et al. The first consecutive 5000 patients with Coronavirus Disease 2019 from Qatar; a nation-wide cohort study. BMC Infect Dis 2020;: 20: 777.
     [Google Scholar]
  11. Abu-Raddad LJ, Chemaitelly H, Ayoub HH, Al Kanaani Z, Al Khal A, Al Kuwari E, et al. Characterizing the Qatar advanced-phase SARS-CoV-2 epidemic. Sci Rep 2021;: 11: 6233.
     [Google Scholar]
  12. Fajnzylber J, Regan J, Coxen K, Corry H, Wong C, Rosenthal A, et al. SARS-CoV-2 viral load is associated with increased disease severity and mortality. Nat Commun 2020;: 11: 5493.
     [Google Scholar]
  13. Wang Y, Zhang D, Du G, Du R, Zhao J, Jin Y, et al. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet 2020;: 395: 1569–78.
     [Google Scholar]
  14. Goldberg E, Ben Zvi H, Sheena L, Sofer S, Krause I, Sklan EH, et al. A real-life setting evaluation of the effect of remdesivir on viral load in COVID-19 patients admitted to a large tertiary centre in Israel. Clin Microbiol Infect 2021;: 27: 917.e1–4.
     [Google Scholar]
  15. Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA 2020;: 323: 1574–81.
     [Google Scholar]
  16. Cummings MJ, Baldwin MR, Abrams D, Jacobson SD, Meyer BJ, Balough EM, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet 2020;: 395: 1763–70.
     [Google Scholar]
  17. Benfield T, Bodilsen J, Brieghel C, Harboe ZB, Helleberg M, Holm C, et al. Improved survival among hospitalized patients with COVID-19 treated with remdesivir and dexamethasone. A nationwide population-based cohort study. Clin Infect Dis 2021;: 73: 2031–6.
     [Google Scholar]
  18. WHO Solidarity Trial Consortium, Pan H, Peto R, Henao-Restrepo AM, Preziosi MP, Sathiyamoorthy V, et al. Repurposed antiviral drugs for Covid-19 - Interim WHO solidarity trial results. N Engl J Med 2021;: 384: 497–511.
     [Google Scholar]
  19. Pallotto C, Blanc P, Esperti S, Suardi LR, Gabbuti A, Vichi F, et al. Remdesivir treatment and transient bradycardia in patients with coronavirus diseases 2019 (COVID-19). J Infect 2021;: 83: 237–79.
     [Google Scholar]
  20. Touafchia A, Bagheri H, Carrié D, Durrieu G, Sommet A, Chouchana L, et al. Serious bradycardia and remdesivir for coronavirus 2019 (COVID-19): a new safety concerns. Clin Microbiol Infect 2021;: 27: 791.e5–8.
     [Google Scholar]
  21. Grein J, Ohmagari N, Shin D, Diaz G, Asperges E, Castagna A, et al. Compassionate use of remdesivir for patients with severe Covid-19. N Engl J Med 2020;: 382: 2327–36.
     [Google Scholar]
  22. Olender SA, Perez KK, Go AS, Balani B, Price-Haywood EG, Shah NS, et al. Remdesivir for severe coronavirus disease (COVID-19) versus a cohort receiving standard of care. Clin Infect Dis 2021;: 73: e4166–74.
     [Google Scholar]
/content/journals/10.5339/qmj.2022.25
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Remdesivir for patients with Coronavirus disease 2019 pneumonia requiring high oxygen support
Qatar Medical Journal 2022, 25 (2022); https://doi.org/10.5339/qmj.2022.25
/content/journals/10.5339/qmj.2022.25
/content/journals/10.5339/qmj.2022.25
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  • Article Type: Short Communication
Keyword(s): bradycardia, coronavirus, intensive care unit, mechanical ventilation, remdesivir and severe pneumonia

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