Title : Clinical profile and outcome of adult covid-19 patients treated with remdesivir in a tertiary infectious disease hospital in manila, philippines: retrospective cohort study
Background: Multiple therapeutic agents have been demonstrated to provide benefits against COVID-19. Clinical trials which evaluated remdesivir for SARS-CoV-2 infection had shown efficacy in disease recovery and mortality and it is of equal importance to determine the onset of treatment with remdesivir which can prevent progression to a more severe disease.
Objective: The study aims to describe the baseline characteristics and outcomes of patients treated with remdesivir and to compare the clinical outcome of patients given with remdesivir within and after seven days of symptom onset.
Design: An observational, retrospective study was carried out at a single-center in Manila, Philippines involving COVID-19 confirmed patients from June 2020 to January 2021.
Results: Out of the 47 patients included in the study, majority were above 60 years old. The most common comorbidities were hypertension and diabetes mellitus and the most common initial symptoms were fever, cough, and dyspnea. Fourteen received remdesivir within 7 days and thirty-three patients received remdesivir after 7 days. Median duration of hospital stay was 15 days, with no significant difference between the two groups, while median duration from symptom onset to hospital discharge was significantly shorter in the early remdesivir group (18.5 vs 23 days). Oxygen supplementation in the present study had an overall median duration of 11 days with those who received remdesivir earlier had shorter duration of oxygen supplementation (9.5 days) than the other group (11 days). All patients who received remdesivir within seven days from symptom onset were discharged and did not need higher forms of oxygenation. Endotracheal intubation (9%) and mortality (9%) were all observed in the late remdesivir group.
Conclusion: Early administration of remdesivir may reduce disease progression as patients treated with remdesivir within seven days from symptom onset had significantly earlier recovery; lesser duration of oxygen supplementation, lesser chance to progress to a higher form of oxygenation, and lesser chance of mortality.
Keywords: COVID-19, remdesivir, Southeast Asia, Philippines
Audience take away:
• The paper presents a single-center experience on COVID-19 epidemiology and treatment outcome with remdesivir.
• This study can add to the existing body of knowledge on the effect of remdesivir in COVID-19 especially in the timing of giving treatment.
• The study can aid clinicians on decision-making in the management of COVID-19.
• Data and results of this research can augment future studies which will seek to determine the ideal
period for the initiation of remdesivir in hospitalized patients; as well as in creation of treatment
protocols within hospitals and institutions.