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Title: Remdesivir versus standard-of-care for severe Coronavirus disease 2019 Infection: an analysis of 28-day mortality
Authors: Olender, Susan A.
Walunas, Theresa L.
Martinez, Esteban
Perez, Katherine K.
Castagna, Antonella
Wang, Su
Kurbegov, Dax
Goyal, Parag
Ripamonti, Diego
Balani, Bindu
De Rosa, Francesco G.
De Wit, Stéphane
Kim, Shin-Woo
Diaz, George
Bruno, Raffaele
Mullane, Kathleen M.
Lye, David C.
Gottlieb, Robert L.
Haubrich, Richard H.
Chokkalingam, Anand P.
Wu, George
Diaz-Cuervo, Helena
Brainard, Diana M.
Lee, I-Heng
Hu, Hao
Lin, Lanjia
Osinusi, Anu O.
Bernardino, Jose I.
Boffito, Marta
Keywords: Science::Medicine
Issue Date: 2021
Source: Olender, S. A., Walunas, T. L., Martinez, E., Perez, K. K., Castagna, A., Wang, S., Kurbegov, D., Goyal, P., Ripamonti, D., Balani, B., De Rosa, F. G., De Wit, S., Kim, S., Diaz, G., Bruno, R., Mullane, K. M., Lye, D. C., Gottlieb, R. L., Haubrich, R. H., ...Boffito, M. (2021). Remdesivir versus standard-of-care for severe Coronavirus disease 2019 Infection: an analysis of 28-day mortality. Open Forum Infectious Diseases, 8(7), ofab278-.
Journal: Open Forum Infectious Diseases
Abstract: Background: Remdesivir is approved by the US Food and Drug Administration for the treatment of patients hospitalized with coronavirus disease 2019 (COVID-19) and has been shown to shorten time to recovery and improve clinical outcomes in randomized trials. Methods: This was the final day 28 comparative analysis of data from a phase 3, randomized, open-label study comparing 2 remdesivir regimens (5 vs 10 days, combined for this analysis [remdesivir cohort]) and a real-world retrospective longitudinal cohort study of patients receiving standard-of-care treatment (nonremdesivir cohort). Eligible patients, aged ≥18 years, had confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), oxygen saturation ≤94% on room air or required supplemental oxygen, with pulmonary infiltrates. Propensity score matching (up to 1:10 ratio) was used to ensure comparable populations. We assessed day 14 clinical recovery (determined using a 7-point ordinal scale) and day 28 all-cause mortality (coprimary endpoints). Results: A total of 368 (remdesivir) and 1399 (nonremdesivir) patients were included in the matched analysis. The day 14 clinical recovery rate was significantly higher among the remdesivir versus the nonremdesivir cohort (65.2% vs 57.1%; odds ratio [OR], 1.49; 95% confidence interval [CI], 1.16–1.90; P = 0.002). The day 28 mortality rate was significantly lower in the remdesivir cohort versus the nonremdesivir cohort (12.0% vs 16.2%; OR, 0.67; 95% CI, 0.47–.95; P = .03). Conclusions: Remdesivir was associated with significantly higher rates of day 14 clinical recovery, and lower day 28 mortality, compared with standard-of-care treatment in hospitalized patients with COVID-19. These data, taken together, support the use of remdesivir to improve clinical recovery and decrease mortality from SARS-CoV-2 infection.
ISSN: 2328-8957
DOI: 10.1093/ofid/ofab278
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Organisations: Tan Tock Seng Hospital
Yong Loo Lin School of Medicine
Rights: © The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ( by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact DOI: 10.1093/ofid/ofab278.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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