ABSTRACT
Objective: Evaluate the impact of real life use of remdesivir (RDV) as treatment for hypoxemic SarsCoV2 Pneumonia. Method(s): Of 1155 consecutive adult subjects hospitalised with SarsCov2 infection, we selected only those with cumulative evidence of: 1. positive PCR test;2. Radiologically confirmed pneumonia;3. Hypoxemia and need of supplementary O2 (>= 24%). We compared those treated with RDV versus those receiving Standard of Care (SoC), in terms of mortality, length of hospital stay and secondary effects of treatment. Result(s): 843 subjects were treated with RDV and 312 with SoC. In the RDV group, 97.1% patients were also receiving Dexamethasone (DEXA) and mean age was 69.7 (+/-14.4) years with 61.8% male prevalence, as opposed to the SoC group that registered 73.9 (+/-14.5) years and 49.7% male prevalence. Both groups had similar prevalence of Diabetes, Hypertension and Chronic Lung Disease;Overweight was more prevalent in the RDV group whereas Immunosuppressant conditions and Smoking were more frequent in the SoC subjects. Concerning the proposed outcomes: a) RDV patients had a mean Hospital Stay 4.25 days inferior than SOC subjects (p=0.002);b)The relative risk of death during hospital stay in the RDV group was 0.47 [0.38;0.60] when compared to those in the SoC group;c) 9 subjects in the SoC group (0.03%) and 12 patients in the RDV group (0.014%) had secondary effects attributable to treatment drugs, all resolved with treatment interruption. Conclusion(s): The use of RDV with DEXA in SARSCoV-2 Hypoxemic Pneumonia significantly reduced mortality and hospital stay, and registered no significant side effects in a real life cohort of consecutively enrolled patients.
ABSTRACT
BACKGROUND: Commercial availability of serological tests to evaluate immunoglobulins (Ig) targeting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has grown exponentially since the start of the coronavirus disease 2019 (COVID-19) outbreak. Thorough validation of these tests is important before use as epidemiological tools to infer seroprevalence in specific populations and as diagnostic tools to complement molecular approaches (e.g., quantitative reverse transcription-polymerase chain reaction). METHODS: Commercial serological tests from 11 suppliers were assayed side-by-side using 126 samples from SARS-CoV-2-infected inpatients and 36 from healthy and HIV-infected individuals. RESULTS: The majority of the tests assayed have >95% specificity. For the sensitivity calculation, samples were stratified by days since symptoms onset; sensitivity peaks at 16-21 days for IgM and IgA (maximum 91.2%, Euroimmun) and, dependant on the test, at 16-21 or >21 days for IgG (maximum 94.1%, Snibe). Data from semiquantitative tests show that patients with a severe clinical presentation have lower levels of Ig targeting SARS-CoV-2 at <10 days since symptoms onset and higher levels at >21 days, compared to patients with a non-severe presentation. CONCLUSIONS: This study highlights the heterogeneity of sensitivity and generally high specificity of the serological tests and establishes a basis for their usefulness to complement diagnostic techniques and population seroprevalence studies.