Remdesivir Use in Patients Requiring Mechanical Ventilation due to COVID-19.
Open Forum Infect Dis
; 7(11): ofaa481, 2020 Nov.
Article
in English
| MEDLINE | ID: covidwho-851858
ABSTRACT
BACKGROUND:
Remdesivir has been associated with accelerated recovery of severe coronavirus disease 2019 (COVID-19). However, whether it is also beneficial in patients requiring mechanical ventilation is uncertain.METHODS:
All consecutive intensive care unit (ICU) patients requiring mechanical ventilation due to COVID-19 were enrolled. Univariate and multivariable Cox models were used to explore the possible association between in-hospital death or hospital discharge, considered competing-risk events, and baseline or treatment-related factors, including the use of remdesivir. The rate of extubation and the number of ventilator-free days were also calculated and compared between treatment groups.RESULTS:
One hundred thirteen patients requiring mechanical ventilation were observed for a median of 31 days of follow-up; 32% died, 69% were extubated, and 66% were discharged alive from the hospital. Among 33 treated with remdesivir (RDV), lower mortality (15.2% vs 38.8%) and higher rates of extubation (88% vs 60%), ventilator-free days (median [interquartile range], 11 [0-16] vs 5 [0-14.5]), and hospital discharge (85% vs 59%) were observed. Using multivariable analysis, RDV was significantly associated with hospital discharge (hazard ratio [HR], 2.25; 95% CI, 1.27-3.97; Pâ =â .005) and with a nonsignificantly lower mortality (HR, 0.73; 95% CI, 0.26-2.1; Pâ =â .560). RDV was also independently associated with extubation (HR, 2.10; 95% CI, 1.19-3.73; Pâ =â .011), which was considered a competing risk to death in the ICU in an additional survival model.CONCLUSIONS:
In our cohort of mechanically ventilated patients, RDV was not associated with a significant reduction of mortality, but it was consistently associated with shorter duration of mechanical ventilation and higher probability of hospital discharge, independent of other risk factors.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Language:
English
Journal:
Open Forum Infect Dis
Year:
2020
Document Type:
Article
Affiliation country:
Ofid
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