Clinical outcomes by supplemental oxygen use in remdesivir-treated, hospitalised adults with COVID-19.

Autor: Arber N; Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 6423906, Israel. Electronic address: nadira@tlvmc.gov.il., Shah PL; Royal Brompton Hospital, Sydney Street, SW3 6NP London, United Kingdom; Chelsea and Westminster Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Rd, Chelsea, London SW10 9NH, UK; National Heart and Lung Institute, Imperial College, Guy Scadding Building, Dovehouse St, London SW3 6LY, UK. Electronic address: pallav.shah@imperial.ac.uk., Assoumou L; Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 15 Rue de l'École de Médecine, 75006 Paris, France. Electronic address: lambert.assoumou@iplesp.upmc.fr., Rokx C; Erasmus University Medical Center, Department of Internal Medicine and Department of Medical Microbiology and Infectious Diseases, Wytemaweg 80, 3015 CN Rotterdam, Netherlands. Electronic address: c.rokx@erasmusmc.nl., De Castro N; AP-HP Hôpital Saint-Louis, 1 Av. Claude Vellefaux, 75010 Paris, France. Electronic address: nathalie.de-castro@aphp.fr., Bakhai A; Barnet Hospital, Royal Free London NHS Foundation Trust, Wellhouse Ln, Barnet, EN5 3DJ London, UK. Electronic address: asbakhai@nhs.net., Soriano Viladomiu A; Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, CIBERINF, C. de Villarroel, 170, 08036 Barcelona, Spain. Electronic address: viladomiu@me.com., Mateu L; Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916 Badalona, Barcelona, Spain. Electronic address: lmateu.germanstrias@gencat.cat., Lumbreras C; Hospital Universitario, 12 de Octubre, v. de Córdoba, s/n, 28041 Madrid, Spain. Electronic address: calumbre@ucm.es., Estrada V; Hospital Clinico San Carlos-IdiSSC, Calle del Prof Martín Lagos, 28040 Madrid, Spain. Electronic address: vicente.estrada@salud.madrid.org., Curran A; Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain. Electronic address: acurran@vhebron.net., Sellier PO; AP-HP Hôpital Lariboisière, 2, rue Ambroise Paré, 75475 Paris Cedex 10, France. Electronic address: pierre.sellier@aphp.fr., Duffy A; Research Organisation Kings Cross, The Stanley Building, 7 Pancras Square, N1C 4AG London, UK. Electronic address: Annie.Duffy@rokcservices.com., Fletcher C; Research Organisation Kings Cross, The Stanley Building, 7 Pancras Square, N1C 4AG London, UK. Electronic address: Carl.Fletcher@rokcservices.com., Mozaffari E; Gilead Sciences Inc, 333 Lakeside Dr, Foster City, CA 94404, United States. Electronic address: essy.mozaffari@gilead.com., Haubrich R; Gilead Sciences Inc, 333 Lakeside Dr, Foster City, CA 94404, United States. Electronic address: Richard.Haubrich@gilead.com., Hodgkins P; Gilead Sciences Inc, 333 Lakeside Dr, Foster City, CA 94404, United States. Electronic address: paul.hodgkins@gilead.com., Pozniak A; Chelsea and Westminster Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Rd, Chelsea, London SW10 9NH, UK. Electronic address: anton.pozniak@nhs.net., Raffi F; Centre Hospitalier Universitaire de Nantes and CIC 1413 INSERM, 1 Pl. Alexis-Ricordeau, 44093 Nantes, France. Electronic address: Francois.raffi@wanadoo.fr.
Jazyk: angličtina
Zdroj: Infectious diseases now [Infect Dis Now] 2023 Oct; Vol. 53 (7), pp. 104760. Date of Electronic Publication: 2023 Jul 14.
DOI: 10.1016/j.idnow.2023.104760
Abstrakt: Background: Clinical trials show different effects of remdesivir on clinical outcomes relative to COVID-19 severity at hospital admission; in Europe, there are few real-world data.
Methods: A multicentre, multinational retrospective cohort study in adult patients hospitalised with PCR-confirmed COVID-19 was conducted to understand remdesivir clinical use in different countries and to describe outcomes for patients receiving remdesivir stratified by oxygen use. Primary endpoints were all-cause mortality at day 28 and hospitalisation duration. Patients were categorised by baseline disease severity: no supplemental oxygen (NSO); low flow oxygen ≤ 6 litres (l)/minute (LFO); high flow oxygen > 6 l/minute (HFO).
Results: Four hundred and forty-eight (448) patients (72 [16.1%] HFO; 295 [65.8%] LFO; 81 (18.1%] NSO) were included; median age was 65 years and 64% were male. Mortality was higher in patients on HFO (rate 23.6%) compared to LFO (10.2%; p = 0.001) or NSO (6.2%; p = 0.002). Duration of hospitalisation was longer in patients on HFO (13 days) compared to LFO (9 days; p = 0.003) and NSO (9 days; p = 0.021). Patients who initiated remdesivir ≥ 2 days compared to within a day of hospitalisation had a 4.2 times higher risk of death, irrespective of age, sex, comorbidities, and oxygen support at baseline. Requirement for mechanical ventilation/ECMO and readmission within 28 days of discharge was similar across groups. Remdesivir use and outcomes differed by country.
Conclusions: A higher mortality rate and duration of hospitalisation was seen in remdesivir-treated COVID-19 patients on HFO compared to LFO and NSO. Initiation of remdesivir upon admission as opposed to delayed initiation has a mortality benefit.
Clinical Trials Registration: NCT04847622.
Competing Interests: Declaration of Competing Interest EM, RH, and PH are employees of Gilead Sciences Inc and own stock/stock options. CR received grants from ViiV, Gilead Sciences, Aidsfonds, Dutch Federation Medical Specialist, Erasmus MC, ZonMW, Health∼Holland. AC has received grants/research support, and honoraria or consultation fees from Gilead Sciences, Janssen, MSD, and ViiV. LM has received consultation fees from Gilead Sciences, Angelini and MSD. AS has received honoraria for lectures and advisory boards from Pfizer, MSD, Menarini, Shionogi, Angelini, Roche, and Gilead Sciences. AS has also received a grant from Pfizer and Gilead Sciences.
(Copyright © 2023. Published by Elsevier Masson SAS.)
Databáze: MEDLINE
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