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Treatment effect modifiers in hospitalised patients with COVID-19 receiving remdesivir and dexamethasone.
Leding, Cæcilie; Bodilsen, Jacob; Brieghel, Christian; Harboe, Zitta Barrella; Helleberg, Marie; Holm, Claire; Israelsen, Simone Bastrup; Jensen, Janne; Jensen, Tomas Østergaard; Johansen, Isik Somuncu; Johnsen, Stine; Kirk, Ole; Lindegaard, Birgitte; Meyer, Christian Niels; Mohey, Rajesh; Pedersen, Lars; Nielsen, Henrik; Nielsen, Stig Lønberg; Omland, Lars Haukali; Podlekareva, Daria; Ravn, Pernille; Starling, Jonathan; Storgaard, Merete; Søborg, Christian; Søgaard, Ole Schmeltz; Tranborg, Torben; Wiese, Lothar; Worm, Signe Heide Westring; Christensen, Hanne Rolighed; Benfield, Thomas.
  • Leding C; Center of Research and Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark.
  • Bodilsen J; Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
  • Brieghel C; Department of Infectious Diseases, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.
  • Harboe ZB; Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital - North Zealand, Denmark.
  • Helleberg M; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Holm C; Department of Infectious Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
  • Israelsen SB; Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
  • Jensen J; Center of Research and Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark.
  • Jensen TØ; Department of Medicine, Kolding Hospital, Kolding, Denmark.
  • Johansen IS; Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital - North Zealand, Denmark.
  • Johnsen S; Research Unit for Infectious Diseases, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
  • Kirk O; Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
  • Lindegaard B; Department of Infectious Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
  • Meyer CN; Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital - North Zealand, Denmark.
  • Mohey R; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Pedersen L; Department of Medicine, Zealand University Hospital, Roskilde, Denmark.
  • Nielsen H; Department of Medicine, Herning Hospital, Herning, Denmark.
  • Nielsen SL; Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
  • Omland LH; Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
  • Podlekareva D; Research Unit for Infectious Diseases, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
  • Ravn P; Department of Infectious Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
  • Starling J; Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
  • Storgaard M; Department of Infectious Diseases, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.
  • Søborg C; Department of Infectious Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
  • Søgaard OS; Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
  • Tranborg T; Department of Infectious Diseases, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.
  • Wiese L; Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
  • Worm SHW; Department of Medicine, Esbjerg Hospital, Esbjerg, Denmark.
  • Christensen HR; Department of Medicine, Zealand University Hospital, Roskilde, Denmark.
  • Benfield T; Department of Infectious Diseases, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.
Infect Dis (Lond) ; 55(5): 351-360, 2023 05.
Article in English | MEDLINE | ID: covidwho-2268183
ABSTRACT

BACKGROUND:

The combined effectiveness of remdesivir and dexamethasone in subgroups of hospitalised patients with COVID-19 is poorly investigated.

METHODS:

In this nationwide retrospective cohort study, we included 3826 patients with COVID-19 hospitalised between February 2020 and April 2021. The primary outcomes were use of invasive mechanical ventilation and 30-day mortality, comparing a cohort treated with remdesivir and dexamethasone with a previous cohort treated without remdesivir and dexamethasone. We used inverse probability of treatment weighting logistic regression to assess associations with progression to invasive mechanical ventilation and 30-day mortality between the two cohorts. The analyses were conducted overall and by subgroups based on patient characteristics.

RESULTS:

Odds ratio for progression to invasive mechanical ventilation and 30-day mortality in individuals treated with remdesivir and dexamethasone compared to treatment with standard of care alone was 0.46 (95% confidence interval, 0.37-0.57) and 0.47 (95% confidence interval, 0.39-0.56), respectively. The reduced risk of mortality was observed in elderly patients, overweight patients and in patients requiring supplemental oxygen at admission, regardless of sex, comorbidities and symptom duration.

CONCLUSIONS:

Patients treated with remdesivir and dexamethasone had significantly improved outcomes compared to patients treated with standard of care alone. These effects were observed in most patient subgroups.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Humans Language: English Journal: Infect Dis (Lond) Year: 2023 Document Type: Article Affiliation country: 23744235.2023.2187081

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Humans Language: English Journal: Infect Dis (Lond) Year: 2023 Document Type: Article Affiliation country: 23744235.2023.2187081