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0 0.5 1 1.5 2+ Mortality -42% Improvement Relative Risk Progression -59% Remdesivir  Punzalan et al.  LATE TREATMENT Is late treatment with remdesivir beneficial for COVID-19? Prospective study of 400 patients in Philippines (Oct 2020 - Sep 2021) Higher progression with remdesivir (p=0.0015) Punzalan et al., Frontiers in Immunology, Feb 2023 Favors remdesivir Favors control

Utility of laboratory and immune biomarkers in predicting disease progression and mortality among patients with moderate to severe COVID-19 disease at a Philippine tertiary hospital

Punzalan et al., Frontiers in Immunology, doi:10.3389/fimmu.2023.1123497
Feb 2023  
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Prospective study of 400 hospitalized patients in the Philippines, showing higher progression with remdesivir in unadjusted results, without statistical significance.
Gérard, Wu, Zhou show significantly increased risk of acute kidney injury with remdesivir.
risk of death, 42.0% higher, RR 1.42, p = 0.12, treatment 47 of 224 (21.0%), control 26 of 176 (14.8%).
risk of progression, 58.9% higher, RR 1.59, p = 0.001, treatment 93 of 224 (41.5%), control 46 of 176 (26.1%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Punzalan et al., 28 Feb 2023, prospective, Philippines, peer-reviewed, mean age 56.0, 17 authors, study period October 2020 - September 2021.
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This PaperRemdesivirAll
Utility of laboratory and immune biomarkers in predicting disease progression and mortality among patients with moderate to severe COVID-19 disease at a Philippine tertiary hospital
Felix Eduardo R Punzalan, Jaime Alfonso M Aherrera, Sheriah Laine M De Paz-Silava, Alric V Mondragon, Anna Flor G Malundo, Joanne Jennifer E Tan, Ourlad Alzeus G Tantengco, Elgin Paul B Quebral, Mary Nadine Alessandra R Uy, Ryan C V Lintao, Jared Gabriel L Dela Rosa, Maria Elizabeth P Mercado, Krisha Camille Avenilla, Jonnel B Poblete, Albert B Albay, Aileen S David-Wang, Marissa M Alejandria
Frontiers in Immunology, doi:10.3389/fimmu.2023.1123497
Purpose: This study was performed to determine the clinical biomarkers and cytokines that may be associated with disease progression and in-hospital mortality in a cohort of hospitalized patients with RT-PCR confirmed moderate to severe COVID-19 infection from October 2020 to September 2021, during the first wave of COVID-19 pandemic before the advent of vaccination. Patients and methods: Clinical profile was obtained from the medical records. Laboratory parameters (complete blood count [CBC], albumin, LDH, CRP, ferritin, D-dimer, and procalcitonin) and serum concentrations of cytokines (IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, IL-18, IFN-g, IP-10, TNF-a) were measured on Days 0-3, 4-10, 11-14 and beyond Day 14 from the onset of illness. Regression analysis was done to determine the association of the clinical laboratory biomarkers and cytokines with the primary outcomes of disease progression and mortality. ROC curves were generated to determine the predictive performance of the cytokines. Results: We included 400 hospitalized patients with COVID-19 infection, 69% had severe to critical COVID-19 on admission. Disease progression occurred in Frontiers in Immunology 01
Ethics statement This study was approved by the UP Manila Research Ethics Board (UPMREB 2020-251-01). The patients/participants provided their written informed consent to participate in this study. Author contributions Conceptualization: FP, JA, SP-S, AMo, AMa, JT, OT, EQ, MU, RL, JR, AD-W, and MA. Methodology: FP, JA, SP-S, AMo, AMa, JT, OT, EQ, MU, RL, JR, MM, KA, JP, AD-W, and MA. Formal analysis: FP, JA, SP-S, AMo, AMa, JT, OT, EQ, MU, RL, JR, MM, KA, AA, AD-W, and MA. Investigation: FP, JA, SP-S, AMo, AMa, JT, OT, EQ, MU, RL, JR, MM, KA, AD-W, and MA. Resources: FP, SP-S, and MA. Data curation: JA, SP-S, JT, OT, EQ, MU, RL, JR, MM, KA, and JP. Writingoriginal draft preparation: FP, JA, SP-S, AMo, AMa, JT, OT, EQ, MU, RL, JR, and MM. Writingreview & editing: FP, JA, SP-S, AMo, AMa, OT, MM, and MA. Supervision: FP, JA, SP-S, AMo, AMa, AD-W, and MA. Project administration: FP, JA, SP-S, AD-W, and MA. Funding acquisition: FP, JA, SP-S, AMo, AMa, JT, OT, EQ, MU, RL, JR, AD-W, and MA. All authors contributed to the article and approved the submitted version. Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any..
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Late treatment
is less effective
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