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Article: Clinical Improvement, Outcomes, Antiviral Activity, and Costs Associated With Early Treatment With Remdesivir for Patients With Coronavirus Disease 2019 (COVID-19)

TitleClinical Improvement, Outcomes, Antiviral Activity, and Costs Associated With Early Treatment With Remdesivir for Patients With Coronavirus Disease 2019 (COVID-19)
Authors
Keywordsantiviral activity
clinical improvement
cost
COVID-19
remdesivir
Issue Date2022
PublisherOxford University Press, published in association with Clinical Infectious Diseases. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
Citation
Clinical Infectious Diseases, 2022, v. 74 n. 8, p. 1450–1458 How to Cite?
AbstractBackground: Evidence remains inconclusive on any significant benefits of remdesivir in patients with mild-to-moderate COVID-19. This study explored the disease progression, various clinical outcomes, changes in viral load, and costs associated with early remdesivir treatment among COVID-19 patients. Methods: A territory-wide retrospective cohort of 10 419 patients with COVID-19 hospitalized from 21 January 2020 to 31 January 2021 in Hong Kong was identified. Early remdesivir users were matched with controls using propensity-score matching in a ratio ≤1:4. Study outcomes were time to clinical improvement of at least 1 point on WHO clinical progression scale, hospital discharge, recovery, viral clearance, low viral load, positive IgG antibody, in-hospital death, and composite outcomes of in-hospital death requiring invasive ventilation or intensive care. Results: After multiple imputation and propensity-score matching, median follow-up was 14 days for both remdesivir (n = 352) and control (n = 1347) groups. Time to clinical improvement was significantly shorter in the remdesivir group than that of control (HR: 1.14; 95% CI: 1.01–1.29; P = .038), as well as for achieving low viral load (1.51; 1.24–1.83; P < .001) and positive IgG antibody (1.50; 1.31–1.70; P < .001). Early remdesivir treatment was associated with lower risk of in-hospital death (HR: .58; 95% CI: .34–.99; P = .045), in addition to a significantly shorter length of hospital stay (difference: −2.56 days; 95% CI: −4.86 to −.26; P = .029), without increasing risks of composite outcomes for clinical deterioration. Conclusions: Early remdesivir treatment could be extended to hospitalized patients with moderate COVID-19 not requiring oxygen therapy on admission.
Persistent Identifierhttp://hdl.handle.net/10722/301608
ISSN
2023 Impact Factor: 8.2
2023 SCImago Journal Rankings: 3.308
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, CKH-
dc.contributor.authorLau, TKK-
dc.contributor.authorAu, ICH-
dc.contributor.authorXIONG, X-
dc.contributor.authorLau, EHY-
dc.contributor.authorCowling, BJ-
dc.date.accessioned2021-08-09T03:41:33Z-
dc.date.available2021-08-09T03:41:33Z-
dc.date.issued2022-
dc.identifier.citationClinical Infectious Diseases, 2022, v. 74 n. 8, p. 1450–1458-
dc.identifier.issn1058-4838-
dc.identifier.urihttp://hdl.handle.net/10722/301608-
dc.description.abstractBackground: Evidence remains inconclusive on any significant benefits of remdesivir in patients with mild-to-moderate COVID-19. This study explored the disease progression, various clinical outcomes, changes in viral load, and costs associated with early remdesivir treatment among COVID-19 patients. Methods: A territory-wide retrospective cohort of 10 419 patients with COVID-19 hospitalized from 21 January 2020 to 31 January 2021 in Hong Kong was identified. Early remdesivir users were matched with controls using propensity-score matching in a ratio ≤1:4. Study outcomes were time to clinical improvement of at least 1 point on WHO clinical progression scale, hospital discharge, recovery, viral clearance, low viral load, positive IgG antibody, in-hospital death, and composite outcomes of in-hospital death requiring invasive ventilation or intensive care. Results: After multiple imputation and propensity-score matching, median follow-up was 14 days for both remdesivir (n = 352) and control (n = 1347) groups. Time to clinical improvement was significantly shorter in the remdesivir group than that of control (HR: 1.14; 95% CI: 1.01–1.29; P = .038), as well as for achieving low viral load (1.51; 1.24–1.83; P < .001) and positive IgG antibody (1.50; 1.31–1.70; P < .001). Early remdesivir treatment was associated with lower risk of in-hospital death (HR: .58; 95% CI: .34–.99; P = .045), in addition to a significantly shorter length of hospital stay (difference: −2.56 days; 95% CI: −4.86 to −.26; P = .029), without increasing risks of composite outcomes for clinical deterioration. Conclusions: Early remdesivir treatment could be extended to hospitalized patients with moderate COVID-19 not requiring oxygen therapy on admission.-
dc.languageeng-
dc.publisherOxford University Press, published in association with Clinical Infectious Diseases. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/-
dc.relation.ispartofClinical Infectious Diseases-
dc.rightsThis is a pre-copyedited, author-produced version of an article accepted for publication in Clinical Infectious Diseases following peer review. The version of record Clinical Infectious Diseases, 2022, v. 74 n. 8, p. 1450–1458 is available online at: https://academic.oup.com/cid/article/74/8/1450/6321803 [DOI: https://doi.org/10.1093/cid/ciab631]-
dc.subjectantiviral activity-
dc.subjectclinical improvement-
dc.subjectcost-
dc.subjectCOVID-19-
dc.subjectremdesivir-
dc.titleClinical Improvement, Outcomes, Antiviral Activity, and Costs Associated With Early Treatment With Remdesivir for Patients With Coronavirus Disease 2019 (COVID-19)-
dc.typeArticle-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailLau, TKK: kristytk@hku.hk-
dc.identifier.emailAu, ICH: auchiho@hku.hk-
dc.identifier.emailLau, EHY: ehylau@hku.hk-
dc.identifier.emailCowling, BJ: bcowling@hku.hk-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityLau, EHY=rp01349-
dc.identifier.authorityCowling, BJ=rp01326-
dc.description.naturepostprint-
dc.identifier.doi10.1093/cid/ciab631-
dc.identifier.pmid34265054-
dc.identifier.pmcidPMC8406861-
dc.identifier.hkuros323988-
dc.identifier.volume74-
dc.identifier.issue8-
dc.identifier.spage1450-
dc.identifier.epage1458-
dc.identifier.isiWOS:000756681900001-
dc.publisher.placeUnited States-

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