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Bogusz Jan Aksak-Wąs,1 Daniel Chober,1 Karol Serwin,1 Kaja Scheibe,1 Jolanta Niścigorska-Olsen,2 Anna Niedźwiedź,3 Monika Dobrowolska,3 Katarzyna Żybul,4 Marta Kubacka,4 Agnieszka Zimoń,5 Ewa Hołda,4 Joanna Mieżyńska-Kurtycz,4 Marta Gryczman,6 Grzegorz Jamro,7 Paweł Szakoła,8 Miłosz Parczewski1 1Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University in Szczecin, Szczecin, Poland; 2Department of Infectious, Tropical Diseases and Immune Deficiency, Provincial Hospital, Szczecin, Poland; 3Department of Diabetology and Internal Diseases, Provincial Hospital, Szczecin, Poland; 4Department of Internal Medicine and Oncology, Provincial Hospital, Szczecin, Poland; 5Department of Rheumatology, Department of Rehabilitation, Provincial Hospital, Szczecin, Poland; 6Department of Nephrology and Kidney Transplantation, Dialysis Station, Provincial Hospital, Szczecin, Poland; 7Department of Otolaryngology with the Sub-Department of Otolaryngology for Children, Provincial Hospital, Szczecin, Poland; 8Department of General and Transplant Surgery, Department of Vascular Surgery, Provincial Hospital, Szczecin, PolandCorrespondence: Bogusz Jan Aksak-Wąs, Pomeranian Medical University, Department of Infectious, Tropical Diseases and Immune Deficiency, Arkońska 4, Szczecin, 71-455, Poland, Tel +48918139455, Fax +49918139449, Email bogusz.aw@gmail.comIntroduction: Remdesivir is the first agent with proven clinical efficacy against coronavirus disease 2019 (COVID-19); however, its benefit is associated with early use, and its efficacy has been poorly studied in patients with hemato-oncological diseases, who have an increased risk of a severe course of infection. This study aimed to assess the effects of remdesivir on mortality, mechanical ventilation, and the duration of hospitalization in both the general population and in patients with hemato-oncological diseases.Materials and Methods: Longitudinal data for 4287 patients with confirmed COVID-19 were analyzed, including a subset of 200 individuals with hemato-oncological diseases. In total, 1285 (30.0%) patients received remdesivir, while the remaining patients were treated with other methods. Survival statistics for the 14- and 30-day observation time points were calculated using non-parametric and multivariate Cox models.Results: Mortality for the 14- and 30-day observation time points was notably lower among patients receiving remdesivir (7.2% vs 11.6%, p < 0.001 and 12.7% vs 16.0, p = 0.005, respectively); however, in multivariate models adjusted for age, sex, lung involvement, and lactate dehydrogenase and interleukin-6 levels, the administration of remdesivir did not reduce patient mortality at either the 14-day or 30-day time points. Among patients with haemato-oncological disease, significant survival benefit was observed at 14 and 30 days for patients treated with remdesivir (11.3% vs.16.7% and 24.2% vs 26.1%, respectively; p < 0.001). A favorable effect of remdesivir was also noted for the 14-day time point in multivariate survival analysis (HR:4.03 [95% confidence interval:1.37– 11.88]; p = 0.01).Conclusion: Remdesivir significantly reduced the early mortality rate in COVID-19 patients with comorbid hemato-oncological disease, which emphasizes the need to administer this agent to immunosuppressed patients.Keywords: COVID-19, SARS-COV-2, remdesivir, mortality, hemato-oncology |
