Generic placeholder image

Current Drug Therapy

Author(s): Seyed Yaser Foroghi Ghomi, Abolfazl Mohammadbeigi, Abbas Ahmadi, Sajjad Ahmadpour, Mansoureh Shakeri, Seyed Hasan Adeli, Jamshid Vafaeimanesh, Reihane Tabaraii, Rasoul Shajari, Mostafa Vahedian and Akram Asghari*

DOI: 10.2174/1574885518666230228120343

DownloadDownload PDF Flyer Cite As
Evaluation of the Effectiveness of Remdesivir in the Treatment of COVID-19 Outpatients: A Retrospective Cohort Study

Page: [350 - 356] Pages: 7

  • * (Excluding Mailing and Handling)

Abstract

Background: The outbreak of acute respiratory syndrome with novel coronavirus 2019 (COVID-19) in December 2019 in Wuhan, China, caused a worldwide outbreak of the disease. To treat the disease, some drugs were identified and introduced that did not show a significant effect on the recovery of the disease. Due to the need to manage inpatient beds, this study was conducted to evaluate the effectiveness of Remdesivir in the treatment of outpatients with moderate to severe COVID-19.

Methods: The present study was a retrospective cohort with a convenience sampling method. It was conducted by referring to the records of COVID-19 patients who were referred to the respiratory clinic of Shahid Beheshti Hospital as outpatients in the period from April to August 2021.

Results: This study was conducted on 263 COVID-19 patients with a mean age of 51.16±14.39 years from 19 and 90 years old. Data were collected through a researcher-made checklist and analyzed using SPSS 20. Kolmogorov-Smirnov test, paired t-test, and Mc Nemar's test were used to evaluate the data. The significance level was considered at the level of 0.05.

Conclusion: Findings revealed that no clear correlation was found between hospitalization and death rate compared to other patients. In our study, the risk factors for severe COVID-19 did not affect the rate of hospitalization or death of patients.

Graphical Abstract

[1]
World Health Organization. Director-General’s remarks at the media brieɹng on 2019. Available from: http://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-brie
[2]
Pranata R, Huang I, Lim MA, Yonas E, Vania R, Kuswardhani RAT. Delirium and Mortality in Coronavirus Disease 2019 (COVID-19) – A Systematic Review and Meta-analysis. Arch Gerontol Geriatr 2021; 95: 104388.
[http://dx.doi.org/10.1016/j.archger.2021.104388] [PMID: 33713880]
[3]
Pranata R, Huang I, Raharjo SB. Incidence and impact of cardiac arrhythmias in coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. Indian Pacing Electrophysiol J 2020; 20(5): 193-8.
[http://dx.doi.org/10.1016/j.ipej.2020.08.001] [PMID: 32814094]
[4]
Hollander JE, Carr BG. Virtually perfect? telemedicine for COVID-19. N Engl J Med 2020; 382(18): 1679-81.
[http://dx.doi.org/10.1056/NEJMp2003539] [PMID: 32160451]
[5]
Lam PW, Sehgal P, Andany N, et al. A virtual care program for outpatients diagnosed with COVID-19: a feasibility study. CMAJ Open 2020; 8(2): E407-13.
[http://dx.doi.org/10.9778/cmajo.20200069] [PMID: 32447283]
[6]
Cao B, Wang Y, Wen D, et al. A trial of lopinavir-ritonavir in adults hospitalized with severe COVID-19. N Engl J Med 2020; 382(19): 1787-99. https://www.ncbi.nlm.nih.gov/pubmed/32187464
[http://dx.doi.org/10.1056/NEJMoa2001282] [PMID: 32187464]
[7]
Sadeghi A, Ali Asgari A, Norouzi A, et al. Sofosbuvir and daclatasvir compared with standard of care in the treatment of patients admitted to hospital with moderate or severe coronavirus infection (COVID-19): a randomized controlled trial. J Antimicrob Chemother 2020; 75(11): 3379-85.
[http://dx.doi.org/10.1093/jac/dkaa334] [PMID: 32812039]
[8]
Arévalo AP, Pagotto R. Pórfido J, et al. Ivermectin reduces coronavirus infection in vivo: a mouse experimental model. bioRxiv 2020. Available from: https://www.biorxiv.org/content/10.1101/ 2020.11.02.363242v1
[http://dx.doi.org/10.1101/2020.11.02.363242]
[9]
Self WH, Semler MW, Leither LM, et al. Effect of hydroxychloroquine on clinical status at 14 days in hospitalized patients with COVID-19: a randomized clinical trial. JAMA 2020; 324(21): 2165-76.
[http://dx.doi.org/10.1001/jama.2020.22240] [PMID: 33165621]
[10]
World Health Organization. Corticosteroids for COVID-19: Living guidance. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-Corticosteroids-2020.1
[11]
Kalil AC, Patterson TF, Mehta AK, et al. Baricitinib plus remdesivir for hospitalized adults with COVID-19. N Engl J Med 2021; 384(9): 795-807.
[http://dx.doi.org/10.1056/NEJMoa2031994] [PMID: 33306283]
[12]
Lundgren JD, Grund B, Barkauskas CE, et al. A neutralizing monoclonal antibody for hospitalized patients with COVID-19. N Engl J Med 2021; 384(10): 905-14.
[http://dx.doi.org/10.1056/NEJMoa2033130] [PMID: 33356051]
[13]
Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res 2020; 30(3): 269-71.
[http://dx.doi.org/10.1038/s41422-020-0282-0] [PMID: 32020029]
[14]
Pizzorno A, Padey B, Julien T, et al. Characterization and treatment of SARS-CoV-2 in nasal and bronchial human airway epithelia. Cell Rep Med 2020; 1(4): 100059.
[http://dx.doi.org/10.1016/j.xcrm.2020.100059] [PMID: 32835306]
[15]
Sheahan TP, Sims AC, Graham RL, et al. Broad-spectrum antiviral GS-5734 inhibits both epidemic and zoonotic coronaviruses. Sci Transl Med 2017; 9: eaal3653.
[16]
Mulangu S, Dodd LE, Davey RT. A randomized, controlled trial of Ebola virus disease therapeutics. N Engl J Med 2019; 381: 2293-303.
[17]
Lundgren JD, Babiker AG, Gordin F, et al. INSIGHT START Study Group. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med 2015; 373(9): 795-807.
[http://dx.doi.org/10.1056/NEJMoa1506816] [PMID: 26192873]
[18]
Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: A clinical–therapeutic staging proposal. J Heart Lung Transplant 2020; 39(5): 405-7.
[http://dx.doi.org/10.1016/j.healun.2020.03.012] [PMID: 32362390]
[19]
Pitts J, Li J, Perry JK, et al. Remdesivir and GS-441524 retain antiviral activity against delta, omicron, and other emergent SARS-CoV-2 variants. Antimicrobial Agents and Chemother 2022; 66(6): e0022222.
[20]
Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the treatment of COVID-19 — final report. N Engl J Med 2020; 383(19): 1813-26.
[http://dx.doi.org/10.1056/NEJMoa2007764] [PMID: 32445440]
[21]
Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LFP. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol 2020; 20(6): 363-74.
[http://dx.doi.org/10.1038/s41577-020-0311-8] [PMID: 32346093]
[22]
Weiss A. Jellingsّ M, Sommer MOA. Spatial and temporal dynamics of SARS-CoV-2 in COVID-19 patients: A systematic review and meta-analysis. EBioMedicine 2020; 58: 102916.
[http://dx.doi.org/10.1016/j.ebiom.2020.102916] [PMID: 32711256]
[23]
Hongchao Pan, Richard Peto, Quarraisha Abdool Karim, Marissa Alejandria, Ana Maria Henao-Restrepo, César Hernández García, Marie-Paule Kieny, Reza Malekzadeh, Srinivas Murthy, Marie- Pierre Preziosi, Srinath Reddy, Mirta Roses Periago, Vasee Sathiyamoorthy, John-Arne Røttingen, Soumya Swaminathan, Repurposed antiviral drugs for COVID-19 –interim WHO SOLIDARITY trial results WHO Solidarity trial consortium, medRxiv 2020.10.15.20209817; Now published in New England Journal of Medicine doi: 10.1056/ NEJMoa2023184
[http://dx.doi.org/10.1101/2020.10.15.20209817]
[24]
Campbell JD, Whittington MD, Rind DM, Pearson SD. Alternative pricing models for remdesivir and other potential treatments for COVID-19. 2020. Available from: https://icer-review.org/material/covid-19-second-assessment-update
[25]
Spinner CD, Gottlieb RL, Criner GJ, et al. Effect of remdesivir vs. standard car on clinical status at 11 days in patients with moderate COVID-19: a randomized clinical trial. JAMA 2020; 324(11): 1048-57.
[http://dx.doi.org/10.1001/jama.2020.16349] [PMID: 32821939]
[26]
Goldman JD, Lye DCB, Hui DS, et al. Remdesivir for 5 or 10 days in patients with severe Covid-19. N Engl J Med 2020; 383(19): 1827-37.
[http://dx.doi.org/10.1056/NEJMoa2015301] [PMID: 32459919]
[27]
Fintzi J, Bonnett T, Sweeney DA, et al. Deconstructing the treatment effect of remdesivir in the adaptive coronavirus disease 2019 (COVID-19) treatment trial-1: implications for critical care resource utilization. Clinical Infectious Diseases 2022; Jun 15; 74(12): 2209-17.
[28]
Dougan M, Nirula A, Azizad M, et al. Bamlanivimab plus etesevimab in mild or moderate COVID-19. N Engl J Med 2021; 385(15): 1382-92.
[http://dx.doi.org/10.1056/NEJMoa2102685] [PMID: 34260849]
[29]
Weinreich DM, Sivapalasingam S, Norton T, et al. REGN-COV2, a neutralizing antibody cocktail, in outpatients with COVID-19. N Engl J Med 2021; 384(3): 238-51.
[http://dx.doi.org/10.1056/NEJMoa2035002] [PMID: 33332778]
[30]
Gupta A, Gonzalez-Rojas Y, Juarez E, et al. Early treatment for Covid-19 with SARS-CoV-2 neutralizing antibody sotrovimab. N Engl J Med 2021; 385(21): 1941-50.
[http://dx.doi.org/10.1056/NEJMoa2107934] [PMID: 34706189]