Effectiveness of remdesivir with corticosteroids for COVID-19 patients in intensive care unit: A hospital-based observational study |
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| Authors: | Mariko Hanafusa Nobutoshi Nawa Yuki Goto Tomoki Kawahara Shigeru Miyamae Yutaka Ueki Nobuyuki Nosaka Kenji Wakabayashi Shuji Tohda Ukihide Tateishi Takeo Fujiwara |
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| Affiliation: | 1. Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan;2. Department of Medical Education Research and Development, Tokyo Medical and Dental University, Tokyo, Japan;3. Disaster Medical Care Office, Tokyo Medical and Dental University, Tokyo, Japan;4. Department of Trauma and Acute Critical Care Medical Center, Tokyo Medical and Dental University, Tokyo, Japan;5. Department of Intensive Care Medicine, Tokyo Medical and Dental University, Tokyo, Japan;6. Department of Clinical Laboratory, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan;7. Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo, Japan |
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| Abstract: | The effectiveness of remdesivir on survival in coronavirus disease 2019 (COVID-19), especially in cases treated in the intensive care unit (ICU), is controversial. We investigated the effectiveness of remdesivir with corticosteroids on the survival of COVID-19 patients in a real ICU clinical practice. For laboratory-confirmed COVID-19 patients admitted to the ICU of a tertiary hospital in Tokyo (April 2020–November 2021) and who received corticosteroids, the effectiveness of remdesivir for survival, stratified by interval length (within 9 or 10+ days), was retrospectively analyzed using Cox regression model. A total of 168 patients were included: 35 with no remdesivir use (control), 96 with remdesivir use within 9 days, and 37 with remdesivir use with an interval of 10+ days. In-hospital mortality was 45.7%, 10.4%, and 16.2%, respectively. After adjusting for possible covariates including comorbidities, laboratory data, oxygen demand, or level of pneumonia, remdesivir use within 9 days from symptom onset reduced mortality risk (hazard ratio [HR]: 0.10; 95% confidence interval (CI): 0.025–0.428) compared to the control group. However, remdesivir use with an interval of 10+ days showed no significant association with mortality (HR: 0.42; 95% CI: 0.117–1.524). Among COVID-19 patients who received corticosteroids in ICU, remdesivir use within 9 days from symptom onset was associated with reduced in-hospital mortality risk. |
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| Keywords: | COVID-19 intensive care units mortality pneumonia remdesivir |
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