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      Risk of hospitalization and sequelae in patients with COVID‐19 treated with 3‐day early remdesivir vs. controls in the vaccine and Omicron era: A real‐life cohort study

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          Abstract

          Recently, a benefit from administration of a 3‐day course of early remdesivir (ER) in the outpatients' setting was reported. However, real‐life data on its use is scarce. Therefore, we explored the ER clinical outcome in our outpatients' s cohort, compared to untreated controls. We included all patients who were prescribed ER from February to May 2022 and followed them up for 3 months and compared patients who received treatment with untreated controls. In the two groups the following outcomes were investigated: hospitalization and mortality rate, time of negativization and symptom's resolution, and postacute coronavirus disease 19 (COVID‐19) syndrome prevalence. Overall, 681 patients were analyzed, mostly females (53.6%), and with a median age of 66 years (interquartile range: 54–77), 316 (46.4%) patients received ER, and 365 (53.6%) did not receive antiviral treatment (control group). Overall, 8.5% patients eventually required oxygen support, 8.7% were hospitalized for COVID‐19, and 1.5% died. Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) immunization and ER (adjusted odds ratio [aOR]: 0.049 [0.015; 0.16], p < 0.001) independently reduced hospitalization risk. ER was significantly associated with a shorter duration of SARS‐CoV‐2 positivity at nasopharyngeal swabs (aβ −8.15 [−9.21; −7.09], p < 0.001) and of symptoms (aβ −5.11 [−5.82; −4.39], p < 0.001), and with lower rate of COVID‐19 sequelae compared to control group (aOR: 0.18 [0.10; 0.31], p < 0.001). Even in the SARS‐CoV‐2 vaccination and Omicron era, in patients at high risk of developing severe disease, ER demonstrated to have a good safety profile and to significantly reduce the risk of disease progression and COVID‐19 sequelae compared to untreated controls.

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          Contributors
          (View ORCID Profile)
          Journal
          Journal of Medical Virology
          Journal of Medical Virology
          Wiley
          0146-6615
          1096-9071
          March 2023
          March 27 2023
          March 2023
          : 95
          : 3
          Affiliations
          [1 ] Department of Molecular Medicine, Infectious and Tropical Diseases Unit Padua University Hospital Padua Italy
          [2 ] Infectious Disease Unit, Department of Medical Sciences at Amedeo di Savoia Hospital University of Torino Torino Italy
          [3 ] Department of Hospital Pharmacy Padua University Hospital Padua Italy
          [4 ] Department of Molecular Medicine University of Padua Padua Italy
          Article
          10.1002/jmv.28660
          36905216
          4bdec746-c474-453a-943b-511071766671
          © 2023

          http://onlinelibrary.wiley.com/termsAndConditions#vor

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