Remdesivir Use in Patients Requiring Mechanical Ventilation due to COVID-19

Autor:	Lapadula, Giuseppe, Bernasconi, Davide Paolo, Bellani, Giacomo, Soria, Alessandro, Rona, Roberto, Bombino, Michela, Avalli, Leonello, Rondelli, Egle, Cortinovis, Barbara, Colombo, Enrico, Valsecchi, Maria Grazia, Migliorino, Guglielmo Marco, Bonfanti, Paolo, Foti, Giuseppe, Gambaro, Alessandra, Spolti, Anna, Beretta, Ilaria, Bisi, Luca, Cappelletti, Anna, Chiesa, Elisabetta, Cogliandro, Viola, Columpsi, Paola, Foresti, Sergio, Gustinetti, Giulia, Iannuzzi, Francesca, Pollastri, Ester, Rossi, Marianna, Sabbatini, Francesca, Squillace, Nicola, Ferlicca, Daniela, Mauri, Fabrizia, Giani, Marco, Pozzi, Matteo, Russotto, Vincenzo
Přispěvatelé:	Lapadula, G, Bernasconi, D, Bellani, G, Soria, A, Rona, R, Bombino, M, Avalli, L, Rondelli, E, Cortinovis, B, Colombo, E, Valsecchi, M, Migliorino, G, Bonfanti, P, Foti, G
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	Coronavirus disease 2019 (COVID-19) medicine.medical_treatment critically ill patients antiviral treatment coronavirus remdesivir 030204 cardiovascular system & hematology intensive care unit law.invention Major Articles 03 medical and health sciences 0302 clinical medicine COVID-19 SARS-CoV-2 Interquartile range law Medicine 030212 general & internal medicine Survival analysis Mechanical ventilation Proportional hazards model business.industry Hazard ratio Intensive care unit Infectious Diseases AcademicSubjects/MED00290 Oncology Anesthesia Cohort business
Zdroj:	Open Forum Infectious Diseases
ISSN:	2328-8957
Popis:	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; P = .005) and with a nonsignificantly lower mortality (HR, 0.73; 95% CI, 0.26–2.1; P = .560). RDV was also independently associated with extubation (HR, 2.10; 95% CI, 1.19–3.73; P = .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.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0ea7c0d910771d49d424cea9dc979b70 http://europepmc.org/articles/PMC7651598 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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