A retrospective real-world study of early short-course remdesivir in non-hospitalized COVID-19 patients at high risk for progression : low rate of hospitalization or death, regardless of immunocompetence status
Copyright © 2023 Ramos-Rincón, Pinargote-Celorio, Llenas-García, Moreno-Pérez, González-Cuello, Gonzalez-de-la-Aleja, Martínez-López, Reus, García-López, Rodríguez, Boix and Merino..
Introduction: The evidence for remdesivir therapy in immunocompromised patients is scarce. To evaluate remdesivir (RDV) effectiveness and safety in COVID-19 outpatients at high risk for progression in a real-world setting, we compare the outcome in immunocompromised (IC) patients with that in non-immunocompromised patients. Methods: Two hospitals conducted a retrospective study of all adult patients with mild-to-moderate SARS-CoV-2 infection at high risk for disease progression who were treated as outpatients with a 3-day course of RDV (1st January-30th September 2022). The primary effectiveness endpoint was a composite of any cause of hospitalization or death by day 30. A multiple logistic regression model was built to explore the association between immune status and clinical outcome, estimating adjusted odds ratios [aORs (95% CI)]. Results: We have included 211 patients, of which 57% were males, with a median age of 65 years (IQR 53-77), 70.1% were vaccinated (three or four doses), and 61.1% were IC. The median duration of symptoms before RDV treatment was 3 days (IQR 2-5). During follow-up, 14 (6.6%) patients were hospitalized, of which 6 (2.8%) were hospitalized for COVID-19 progression. No patient required mechanical ventilation, and two patients died (non-COVID-19-related). After accounting for potential confounders, only anti-CD20 treatment was associated with the composed outcome [aOR 5.35 (1.02-27.5, 95% CI)], whereas the immunocompetence status was not [aOR 1.94 (0.49-7.81, 95% CI)]. Conclusion: Early COVID-19 outpatient treatment with a 3-day course of remdesivir in vaccinated patients at high risk for disease progression during the Omicron surge had a good safety profile. It was associated with a low rate of all-cause hospitalization or death, regardless of immunocompetence status.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
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| Enthalten in: |
Frontiers in pharmacology - 14(2023) vom: 01., Seite 1218650 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ramos-Rincón, José Manuel [VerfasserIn] |
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| Links: |
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| Themen: |
Hospitalization SARS-CoV-2 infection |
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| Anmerkungen: |
Date Revised 27.10.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3389/fphar.2023.1218650 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363733949 |
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| 100 | 1 | |a Ramos-Rincón, José Manuel |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A retrospective real-world study of early short-course remdesivir in non-hospitalized COVID-19 patients at high risk for progression |b low rate of hospitalization or death, regardless of immunocompetence status |
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| 520 | |a Introduction: The evidence for remdesivir therapy in immunocompromised patients is scarce. To evaluate remdesivir (RDV) effectiveness and safety in COVID-19 outpatients at high risk for progression in a real-world setting, we compare the outcome in immunocompromised (IC) patients with that in non-immunocompromised patients. Methods: Two hospitals conducted a retrospective study of all adult patients with mild-to-moderate SARS-CoV-2 infection at high risk for disease progression who were treated as outpatients with a 3-day course of RDV (1st January-30th September 2022). The primary effectiveness endpoint was a composite of any cause of hospitalization or death by day 30. A multiple logistic regression model was built to explore the association between immune status and clinical outcome, estimating adjusted odds ratios [aORs (95% CI)]. Results: We have included 211 patients, of which 57% were males, with a median age of 65 years (IQR 53-77), 70.1% were vaccinated (three or four doses), and 61.1% were IC. The median duration of symptoms before RDV treatment was 3 days (IQR 2-5). During follow-up, 14 (6.6%) patients were hospitalized, of which 6 (2.8%) were hospitalized for COVID-19 progression. No patient required mechanical ventilation, and two patients died (non-COVID-19-related). After accounting for potential confounders, only anti-CD20 treatment was associated with the composed outcome [aOR 5.35 (1.02-27.5, 95% CI)], whereas the immunocompetence status was not [aOR 1.94 (0.49-7.81, 95% CI)]. Conclusion: Early COVID-19 outpatient treatment with a 3-day course of remdesivir in vaccinated patients at high risk for disease progression during the Omicron surge had a good safety profile. It was associated with a low rate of all-cause hospitalization or death, regardless of immunocompetence status | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a SARS-CoV-2 early treatment | |
| 650 | 4 | |a hospitalization SARS-CoV-2 infection | |
| 650 | 4 | |a immunosupressed SARS-CoV2 treatment | |
| 650 | 4 | |a outpatient SARS-CoV-2 treatment | |
| 650 | 4 | |a remdesivir | |
| 700 | 1 | |a Pinargote-Celorio, Héctor |e verfasserin |4 aut | |
| 700 | 1 | |a Llenas-García, Jara |e verfasserin |4 aut | |
| 700 | 1 | |a Moreno-Pérez, Oscar |e verfasserin |4 aut | |
| 700 | 1 | |a González-Cuello, Inmaculada |e verfasserin |4 aut | |
| 700 | 1 | |a Gonzalez-de-la-Aleja, Pilar |e verfasserin |4 aut | |
| 700 | 1 | |a Martínez-López, Belén |e verfasserin |4 aut | |
| 700 | 1 | |a Reus, Sergio |e verfasserin |4 aut | |
| 700 | 1 | |a García-López, María |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez, Juan Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Boix, Vicente |e verfasserin |4 aut | |
| 700 | 1 | |a Merino, Esperanza |e verfasserin |4 aut | |
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