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All Studies   Meta Analysis   Recent:  
0 0.5 1 1.5 2+ Mortality 16% Improvement Relative Risk Remdesivir for COVID-19  Pasquini et al.  ICU PATIENTS Is very late treatment with remdesivir beneficial for COVID-19? Retrospective 51 patients in Italy Lower mortality with remdesivir (p=0.03) c19early.org Pasquini et al., J. Antimicrobial Chem.., Aug 2020 Favors remdesivir Favors control

Effectiveness of remdesivir in patients with COVID-19 under mechanical ventilation in an Italian ICU

Pasquini et al., Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkaa321
Aug 2020  
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Retrospective 51 ICU patients under mechanical ventilation, 25 treated with remdesivir, showing lower mortality with treatment.
Gérard, Wu, Zhou show significantly increased risk of acute kidney injury with remdesivir.
This study includes HCQ and remdesivir.
risk of death, 16.2% lower, RR 0.84, p = 0.03, treatment 14 of 25 (56.0%), control 24 of 26 (92.3%), NNT 2.8, adjusted per study, inverted to make RR<1 favor treatment, odds ratio converted to relative risk, multivariate.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Pasquini et al., 23 Aug 2020, retrospective, Italy, peer-reviewed, 9 authors.
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Effectiveness of remdesivir in patients with COVID-19 under mechanical ventilation in an Italian ICU
Zeno Pasquini, Roberto Montalti, Chiara Temperoni, Benedetta Canovari, Mauro Mancini, Michele Tempesta, Daniela Pimpini, Nicoletta Zallocco, Francesco Barchiesi
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkaa321
Background: Remdesivir is a prodrug with in vitro activity against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Its clinical efficacy in patients with COVID-19 under mechanical ventilation remains to be evaluated. Methods: This study includes patients under mechanical ventilation with confirmed SARS-CoV-2 infection admitted to the ICU of Pesaro hospital between 29 February and 20 March 2020. During this period, remdesivir was provided on a compassionate use basis. Clinical characteristics and outcome of patients treated with remdesivir were collected retrospectively and compared with those of patients hospitalized in the same time period. Results: A total of 51 patients were considered, of which 25 were treated with remdesivir. The median (IQR) age was 67 (59-75.5) years, 92% were men and symptom onset was 10 (8-12) days before admission to ICU. At baseline, there was no significant difference in demographic characteristics, comorbidities and laboratory values between patients treated and not treated with remdesivir. Median follow-up was 52 (46-57) days. Kaplan-Meier curves showed significantly lower mortality among patients who had been treated with remdesivir (56% versus 92%, P < 0.001). Cox regression analysis showed that the Charlson Comorbidity Index was the only factor that had a significant association with higher mortality (OR 1.184; 95% CI 1.027-1.365; P = 0.020), while the use of remdesivir was associated with better survival (OR 3.506; 95% CI 1.768-6.954; P < 0.001). Conclusions: In this study the mortality rate of patients with COVID-19 under mechanical ventilation is confirmed to be high. The use of remdesivir was associated with a significant beneficial effect on survival.
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Late treatment
is less effective
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