Compassionate Use of Remdesivir in Pregnant Women With Severe Coronavirus Disease 2019.

Autor:	Burwick RM; Cedars Sinai Medical Center, Obstetrics and Gynecology, Los Angeles, California, USA., Yawetz S; Brigham and Women's Hospital, Department of Medicine, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA., Stephenson KE; Harvard Medical School, Boston, Massachusetts, USA.; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Collier AY; Harvard Medical School, Boston, Massachusetts, USA.; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Sen P; Harvard Medical School, Boston, Massachusetts, USA.; Massachusetts General Hospital, Boston, Massachusetts, USA., Blackburn BG; Stanford University, Stanford, California, USA., Kojic EM; Mount Sinai Morningside and Mount Sinai West, New York, New York, USA., Hirshberg A; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Suarez JF; Stanford University, Stanford, California, USA., Sobieszczyk ME; Columbia University, New York, New York, USA., Marks KM; Weill Cornell Medicine, New York, New York, USA., Mazur S; NewYork Presbyterian/Weill Cornell Medical Center, New York, New York, USA., Big C; Beaumont Hospital, Dearborn, Michigan, USA., Manuel O; Lausanne University Hospital, Lausanne, Switzerland., Morlin G; Valley Medical Center, Renton, Washington, USA., Rose SJ; Stamford Health, Stamford, Connecticut, USA., Naqvi M; Cedars Sinai Medical Center, Obstetrics and Gynecology, Los Angeles, California, USA., Goldfarb IT; Harvard Medical School, Boston, Massachusetts, USA.; Massachusetts General Hospital, Boston, Massachusetts, USA., DeZure A; Gilead Sciences Inc, Foster City, California, USA., Telep L; Gilead Sciences Inc, Foster City, California, USA., Tan SK; Gilead Sciences Inc, Foster City, California, USA., Zhao Y; Gilead Sciences Inc, Foster City, California, USA., Hahambis T; Gilead Sciences Inc, Foster City, California, USA., Hindman J; Gilead Sciences Inc, Foster City, California, USA., Chokkalingam AP; Gilead Sciences Inc, Foster City, California, USA., Carter C; Gilead Sciences Inc, Foster City, California, USA., Das M; Gilead Sciences Inc, Foster City, California, USA., Osinusi AO; Gilead Sciences Inc, Foster City, California, USA., Brainard DM; Gilead Sciences Inc, Foster City, California, USA., Varughese TA; Rutgers New Jersey Medical School, Newark, New Jersey, USA., Kovalenko O; Rutgers New Jersey Medical School, Newark, New Jersey, USA., Sims MD; Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA., Desai S; Hackensack Meridian, Hackensack University Medical Center, Hackensack, New Jersey, USA., Swamy G; Duke University School of Medicine, Durham, North Carolina, USA., Sheffield JS; Johns Hopkins Medicine, Baltimore, Maryland, USA., Zash R; Harvard Medical School, Boston, Massachusetts, USA.; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA., Short WR; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2021 Dec 06; Vol. 73 (11), pp. e3996-e4004.
DOI:	10.1093/cid/ciaa1466
Abstrakt:	Background: Remdesivir is efficacious for severe coronavirus disease 2019 (COVID-19) in adults, but data in pregnant women are limited. We describe outcomes in the first 86 pregnant women with severe COVID-19 who were treated with remdesivir. Methods: The reported data span 21 March to 16 June 2020 for hospitalized pregnant women with polymerase chain reaction-confirmed severe acute respiratory syndrome coronavirus 2 infection and room air oxygen saturation ≤94% whose clinicians requested remdesivir through the compassionate use program. The intended remdesivir treatment course was 10 days (200 mg on day 1, followed by 100 mg for days 2-10, given intravenously). Results: Nineteen of 86 women delivered before their first dose and were reclassified as immediate "postpartum" (median postpartum day 1 [range, 0-3]). At baseline, 40% of pregnant women (median gestational age, 28 weeks) required invasive ventilation, in contrast to 95% of postpartum women (median gestational age at delivery 30 weeks). By day 28 of follow-up, the level of oxygen requirement decreased in 96% and 89% of pregnant and postpartum women, respectively. Among pregnant women, 93% of those on mechanical ventilation were extubated, 93% recovered, and 90% were discharged. Among postpartum women, 89% were extubated, 89% recovered, and 84% were discharged. Remdesivir was well tolerated, with a low incidence of serious adverse events (AEs) (16%). Most AEs were related to pregnancy and underlying disease; most laboratory abnormalities were grade 1 or 2. There was 1 maternal death attributed to underlying disease and no neonatal deaths. Conclusions: Among 86 pregnant and postpartum women with severe COVID-19 who received compassionate-use remdesivir, recovery rates were high, with a low rate of serious AEs. (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.)
Databáze:	MEDLINE
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