Diaz: Remdesivir and Mortality in Patients with COVID-19

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Remdesivir and Mortality in Patients with COVID-19

Diaz et al., Clinical Infectious Diseases, doi:10.1093/cid/ciab698

Diaz et al., Remdesivir and Mortality in Patients with COVID-19, Clinical Infectious Diseases, doi:10.1093/cid/ciab698

Aug 2021 Source PDF

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Retrospective 1138 hospitalized patients in the USA, 286 treated with remdesivir, showing lower mortality with treatment.

Age was not included in the adjustments (authors excluded variables that contributed to another score, in this case age is in Pneumonia Severity Index).

[Gérard, Wu, Zhou] show significantly increased risk of acute kidney injury with remdesivir.

1. Gérard et al., Clinical Pharmacology & Therapeutics, doi:10.1002/cpt.2145, Remdesivir and Acute Renal Failure: A Potential Safety Signal From Disproportionality Analysis of the WHO Safety Database, https://onlinelibrary.wiley.com/doi/pdf/10.1002/cpt.2145.

2. Wu et al., Frontiers in Pharmacology, doi:10.3389/fphar.2022.692828, Acute Kidney Injury Associated With Remdesivir: A Comprehensive Pharmacovigilance Analysis of COVID-19 Reports in FAERS, https://www.frontiersin.org/articles/10.3389/fphar.2022.692828/full.

3. Zhou et al., Frontiers in Pharmacology, doi:10.3389/fphar.2022.833679, Acute Kidney Injury and Drugs Prescribed for COVID-19 in Diabetes Patients: A Real-World Disproportionality Analysis, https://www.frontiersin.org/articles/10.3389/fphar.2022.833679/full.

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risk of death, 34.7% lower, HR 0.65, p = 0.01, treatment 33 of 286 (11.5%), control 173 of 852 (20.3%), NNT 11, adjusted per study, odds ratio converted to relative risk, multivariable, Cox proportional hazards, day 60.

risk of death, 44.0% lower, HR 0.56, p = 0.04, treatment 286, control 852, adjusted per study, multivariable, Cox proportional hazards, day 30, RR approximated with OR.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Diaz et al., 19 Aug 2021, retrospective, USA, peer-reviewed, 45 authors.

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MD George A Diaz, PharmD, BCIDP Alyssa B Christensen, MD Tobias Pusch, MD Delaney Goulet, PhD Shu-Ching Chang, PhD Gary L Grunkemeier, MISM Paul A Mckelvey, MD Ari Robicsek, MS Tom French, MD Guilford T Parsons, MPH Glenn Doherty, MS Charles Laurenson, Ryan Roper, MD Jennifer Hadlock, MD, MPH Cameron J Cover, PharmD, BCPS Brent Footer, MD Philip Robinson, ARNP Mary Micikas, MD Jennifer E Marfori, Charlotte Cronenweth, Yogavedya Mukkamala, Jamie Mackiewicz, Ekra Rai, Martha Dickinson Matson, RN Jodie Davila, Justin Rueda, Reda Tipton, Heather Algren Rn, MD Brittney C Ward, MD Stephen Malkoski, MD Tyler Gluckman, PharmD Gregory B Tallman, MD Henry Arguinchona, MD Terese C Hammond, MD Steven Standaert, MD Joshua Christensen, MD, MPH Jose F Echaiz, MD, MPH Robert Choi, MD Daniel Mcclung, MD Albert Pacifico, MD Martin Fee, MD Farjad Sarafian, MD, PhD William R Berrington, MD, MPH Jason D Goldman

doi:10.1093/cid/ciab698/6352176

From an early retrospective cohort of hospitalized COVID-19 patients, remdesivir use is associated with lower mortality compared to best supportive care. The effect remains the same for the subgroup of patients requiring low flow oxygen at baseline, similar to the ACTT-1 results.

Disclaimer The manufacturer of RDV (Gilead Sciences, Inc.) and the sponsor of ACTT-1 (NIH NIAID) approved the reuse of data for this study, but was not involved in study design, data preparation, data analysis or manuscript preparation. A c c e p t e d M a n u s c r i p t

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Late treatment
is less effective

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