Remdesivir Reduces Mortality Risk Among Patients Hospitalized With COVID-19

In-hospital mortality risk was significantly reduced among patients hospitalized with COVID-19 infection who received remdesivir.

Results of a retrospective study suggest remdesivir significantly reduces the risk of in-hospital mortality among patients hospitalized with COVID-19 infection. These findings were published in JAMA Network Open.

Researchers conducted a retrospective cohort study between 2020 and 2021 to assess the effects of remdesevir on mortality risk among patients hospitalized with COVID-19 infection. Patients who did and did not (controls) receive redemesivir were propensity score-matched using a 2-stage approach. The primary outcome was the risk of all-cause in-hospital mortality within 28 days of remdesivir initiation.

Among patients in the remdesivir (n=24,856) and control (n=24,856) cohorts included in the matched analysis, the median age was 68 and 67 years, 47.9% and 47.9% were women, and 64.2% and 64.2% did not receive any supplemental oxygen during hospitalization, respectively. Overall, 29.6% of patients were admitted to an intensive care unit, and the median time between hospitalization and receipt of redemsivir was 1 day.

The rate of mortality was 14.3% among remdesivir recipients compared with 15.2% among patients in the control cohort. Overall, remdesivir was associated with a 17% decreased risk of mortality (hazard ratio [HR], 0.83; 95% CI, 0.79-0.87).

Remdesivir was associated with decreased mortality risk among a subset of patients who received high-flow oxygen or noninvasive ventilation (HR, 0.77; 95% CI, 0.71-0.85). There also was an association between decreased mortality risk and remdesivir among patients who received extracorporeal oxygenation or invasive mechanical ventilation (HR, 0.83; 95% CI, 0.73-0.95), low-flow oxygen (HR, 0.81; 95% CI, 0.73-0.90), and those who did not receive supplemental support (HR, 0.88; 95% CI, 0.82-0.94).

Future areas of research include assessing the association of remdesivir treatment with inpatient mortality during the circulation of different variants and relative to time from symptom onset.

Similar findings were observed in the post-hoc analysis.

This study may have been limited as more patients with severe COVID-19 received remdesivir and were therefore unavailable for inclusion in the control cohort.

According to the researchers, “Future areas of research include assessing the association of remdesivir treatment with inpatient mortality during the circulation of different variants and relative to time from symptom onset.”

Disclosure: Multiple authors declared affiliations with industry. Please see the original reference for a full list of disclosures.

References:

Chokkalingam AP, Hayden J, Goldman JD, et al. Association of remdesivir treatment with mortality among hospitalized adults with COVID-19 in the United States. JAMA Netw Open. 2022;5(12):e2244505. doi:10.1001/jamanetworkopen.2022.44505