Abstract
Objectives: Remdesivir is the current recommended anti-viral treatment in moderate-to-severe COVID-19. However, data on impact of timing of therapy, efficacy, and safety are limited. We evaluated the impact of timing of remdesivir initiation (symptom onset to remdesivir treatment [SORT] interval) on in-hospital all-cause mortality in patients with moderate-to-severe COVID-19.
Methods: This retrospective study was conducted between June 25 and October 3, 2020, at a tertiary care dedicated COVID center in India. Patients with moderate-to-severe COVID-19 (moderate: SpO 2 <94%; severe: SpO 2 <90%) were included. The main outcome was impact of SORT interval on in-hospital all-cause mortality. Subgroups were formed and analyzed based on SORT interval.
Results: Of 350 patients treated with remdesivir, 346 were included in the final analysis. Overall, 76 (22.0%) patients died (moderate: 3 [2.8%], severe: 73 [30.8%]). All-cause mortality was significantly lower in patients with SORT interval ≤9 days (n = 260) vs SORT interval >9 days (n = 86; 18.1% vs 33.7%; p = 0.004). The odds of death were significantly lower in patients with SORT interval ≤9 days vs >9 days (odds ratio = 0.43; 95% CI, 0.25-0.75; p = 0.003).
Conclusion: Remdesivir initiation ≤9 days from symptom onset was associated with mortality benefit, defining a treatment window and reinforcing the need for appropriately-timed remdesivir in moderate-to-severe COVID-19.
Keywords: COVID-19; Earlier initiation; Mortality; Remdesivir; Safety; Severe.
【저자키워드】 COVID-19, Mortality, Safety, Remdesivir, severe, Earlier initiation, 【초록키워드】 Treatment, Efficacy, therapy, India, Remdesivir, outcome, severe, COVID, Retrospective study, Patient, death, Care, Analysis, Odds ratio, final analysis, In-hospital, symptom onset, Anti-viral treatment, 95% CI, moderate-to-severe COVID-19, subgroups, all-cause mortality, Final, 350 patients, significantly lower, benefit, analyzed, evaluated, conducted, treated, 350 patient, patients died, 【제목키워드】 Treatment, Remdesivir, Analysis, lower mortality,