Remdesivir treatment in hospitalized patients with COVID-19: a comparative analysis of in-hospital all-cause mortality in a large multi-center observational cohort
Mozaffari et al.,
Remdesivir treatment in hospitalized patients with COVID-19: a comparative analysis of in-hospital all-cause..,
Clinical Infectious Diseases, doi:10.1093/cid/ciab875
Retrospective 28,855 remdesivir patients with PSM matched controls, showing lower mortality with treatment.
[Gérard, Wu, Zhou] show significantly increased risk of acute kidney injury with remdesivir.
risk of death, 12.0% lower, HR 0.88, p = 0.003, treatment 4,441 of 28,855 (15.4%), control 5,499 of 28,855 (19.1%), NNT 27, adjusted per study, 28 days, PSM, Cox proportional hazards.
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risk of death, 24.0% lower, HR 0.76, p < 0.001, treatment 3,057 of 28,855 (10.6%), control 4,437 of 28,855 (15.4%), NNT 21, adjusted per study, 14 days, PSM, Cox proportional hazards.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Mozaffari et al., 1 Oct 2021, retrospective, USA, peer-reviewed, 12 authors.
Abstract: Remdesivir treatment in hospitalized patients with COVID-19: a comparative analysis of inhospital all-cause mortality in a large multi-center observational cohort
Essy Mozaffari1, Aastha Chandak2, Zhiji Zhang2, Shuting Liang1, Mark Thrun1, Robert L Gottlieb3,
Haubrich1
1
Gilead Sciences, 333 Lakeside Drive, Foster City, CA, USA 94404; 2 Certara, 295 Madison Ave, 23rd Fl,
New York, NY, USA 10017; 3Baylor University Medical Center Dallas; Baylor Scott and White Heart
and Vascular Hospital; Baylor Scott and White The Heart Hospital Plano, and Baylor Scott and White
Research Institute, 3410 Worth St, Suite 250, Dallas TX, USA 75246; 4Division of Infectious Diseases,
Brigham and Women’s Hospital, Harvard Medical School, 65 Landsdowne St, Cambridge, MA, USA
02139; 5Division of Infectious Diseases, Brigham and Women’s Hospital, 75 Francis Street, Boston,
MA, USA 02115; 6University of North Carolina, 130 Mason Farm Road, Chapel Hill, NC, USA 27599
Corresponding author details:
Robert L Gottlieb, MD, PhD
Advanced Heart Failure and Transplant Cardiologist
Baylor University Medical Center & Baylor Scott and White Research Institute
3410 Worth St, Suite 250, Dallas, TX, 75246 United States
Email: robert.gottlieb@bswhealth.org
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of
America.
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Daniel R. Kuritzkes4, Paul E. Sax5, David A. Wohl6, Roman Casciano2, Paul Hodgkins1, Richard
Summary: Patients treated with remdesivir had a significantly lower risk of mortality compared to
those not treated with remdesivir. Consistent with other studies, this large study of U.S. clinical
practice supports remdesivir as a treatment option for appropriate COVID-19 patients.
2
Abstract:
Background: Remdesivir (RDV) improved clinical outcomes among hospitalized COVID-19 patients in
randomized trials, but data from clinical practice are limited.
Nov 2020 and treated with RDV within two-days of hospitalization vs. those not receiving RDV during
their hospitalization using the Premier Healthcare Database. Preferential within-hospital propensity
score matching with replacement was used. Additionally, patients were also matched on baseline
oxygenation level (no supplemental oxygen charges (NSO), low-flow oxygen (LFO), high-flow
oxygen/non-invasive ventilation (HFO/NIV) and invasive mechanical ventilation/ECMO (IMV/ECMO)
and two-month admission window and excluded if discharged within 3-days of admission (to exclude
anticipated discharges/transfers within 72-hrs consistent with ACTT-1 study). Cox Proportional
Hazards models were used to assess time to 14-/28-day mortality overall and for patients on NSO,
LFO, HFO/NIV and IMV/ECMO.
Results: 28,855 RDV patients were matched to 16,687 unique non-RDV patients. Overall, 10.6% and
15.4% RDV patients..
Late treatment
is less effective
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