Remdesivir in COVID-19 pneumoniae in a medical unit

ABSTRACT

Background: Remdesivir (REM) is authorized to cure COVID-19 pneumonia with low oxygen supplementation. We evaluated the effect of combination of REM and usual treatment with enoxaparin and dexamethasone on clinical outcome. Methods: A prospective open study with REM (200 mg first day and then 100 mg /day for four days) was performed in a medical unit with critical sector in the period of half november 2021 and half January 2022 . All COVID-19 patients requiring supplemental low O2 therapy were treated with enoxaparin (4000 unit/day for almost patients) and dexamethasone (6 mg);three patients were treated even with baricitinib for rapid pulmonary deterioration. The primary endpoint was the final outcome with discharge from Hospital. Results: 33 COVID-19 patients were enrolled, 20 men, mean age 66 y (range 41-87);14 patients with a complete vaccinal schedule;therapy was started 1-2 days after entering the hospital. The lenght of hospitalization was 7.5 days with a range of 7-25;mortality in two patients (one not vaccinated), need of intensive care in 10 patients with favorouble evolution (3 with oral intubation and seven with non invasive ventilation support);at the end, 31 patients were discharged or at home or at sub acute unit. We did not observe major side effects, cough, headache, moderate increase of transaminases Conclusions: REM treatment, associated with heparin, dexamethasone and oxigen supplement, especially if started early, is safety and associated with reduced length of hospitalization and reduction mortality.