Effectiveness of remdesivir with and without dexamethasone in hospitalized patients with COVID-19
Garibaldi et al.,
Effectiveness of remdesivir with and without dexamethasone in hospitalized patients with COVID-19,
medRxiv, doi:10.1101/2020.11.19.20234153 (Preprint)
Retrospective 303 remdesivir patients and 303 matched controls showing significantly faster clinical improvement, and lower (but not statistically significant) mortality.
[Gérard, Zhou] show significantly increased risk of acute kidney injury with remdesivir.
risk of death, 20.0% lower, HR 0.80, p = 0.44, treatment 23 of 303 (7.6%), control 45 of 303 (14.9%), adjusted per study.
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risk of no improvement at day 28, 35.0% better, RR 0.65, p < 0.001, treatment 52 of 303 (17.2%), control 80 of 303 (26.4%), NNT 11, adjusted per study.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Garibaldi et al., 20 Nov 2020, retrospective, USA, preprint, 10 authors.
Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.11.19.20234153; this version posted November 20, 2020. The copyright holder for this
preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
All rights reserved. No reuse allowed without permission.
Title: Effectiveness of remdesivir with and without dexamethasone in hospitalized patients with
COVID-19
Brian T. Garibaldi MD MEHP1*, Kunbo Wang MS2*, Matthew L. Robinson MD3, Scott L. Zeger
PhD4, Karen Bandeen Roche PhD4, Mei-Cheng Wang PhD4, G. Caleb Alexander MD5, Amita
Gupta MD3, Robert Bollinger MD MPH3, Yanxun Xu PhD2,6
1
Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine,
Baltimore, MD
2
Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD
USA
3
Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD
USA
4
Division of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
USA
5
Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health,
Baltimore, MD USA
6
Division of Biostatistics and Bioinformatics at The Sidney Kimmel Comprehensive Cancer
Center, Johns Hopkins University School of Medicine, Baltimore, MD USA
* Dr. Garibaldi and Mr. Wang contributed equally to this article.
* Dr. Garibaldi and Mr. Wang contributed equally to this article.
BTG, KW, YX contributed to the conception and design of the work, the acquisition, analysis,
and interpretation of data
MR, SZ, KBR, MCW, CA, AG, RB contributed to the conception and design of the work and
interpretation of the data.
All authors contributed to the drafting and revising of the manuscript for important intellectual
content, give final approval of the version to be published and agree to be accountable for all
aspects of the work in ensuring that questions related to the accuracy or integrity of any part of
the work are appropriately investigated and resolved.
Corresponding Author
Brian T. Garibaldi, MD MEHP
Division of Pulmonary and Critical Care Medicine
Johns Hopkins University School of Medicine
1830 East Monument Street
Baltimore, MD 21205
(443) 804-8286
Bgariba1@jhmi.edu
Funding and Support: JH-CROWN received funding from Hopkins inHealth, the Johns
Hopkins Precision Medicine Program. BTG, KW, MR, AG and YX received funding from the
COVID-19 Administrative Supplement for the HHS Region 3 Treatment Center from the Office
of the Assistant Secretary for Preparedness and Response.
1
NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
medRxiv preprint doi: https://doi.org/10.1101/2020.11.19.20234153; this version posted November 20, 2020. The copyright holder for this
preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
All rights reserved. No reuse allowed without permission.
ABSTRACT
Rationale: Remdesivir and dexamethasone reduced the severity of COVID-19 in clinical trials.
However, their individual or combined effectiveness in clinical practice remains unknown.
Objectives: To examine the effectiveness of remdesivir with or without dexamethasone.
Methods: We conducted a multicenter, retrospective cohort study between March 4 and August
29, 2020. Eligible COVID cases were hospitalized patients treated with..
Late treatment
is less effective
Please send us corrections, updates, or comments. Vaccines and
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