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All Studies   Meta Analysis       

Efficacy of Various Treatment Modalities on Patient-related Outcome in Hospitalized COVID-19 Patients – A Retrospective Study

Siraj et al., Indian Journal of Clinical Practice, 32:9
Feb 2022  
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Mortality 53% Improvement Relative Risk Remdesivir for COVID-19  Siraj et al.  LATE TREATMENT Is late treatment with remdesivir beneficial for COVID-19? Retrospective 1,000 patients in India (March - December 2020) Lower mortality with remdesivir (p<0.000001) c19early.org Siraj et al., Indian J. Clinical Pract.., Feb 2022 Favorsremdesivir Favorscontrol 0 0.5 1 1.5 2+
Retrospective 1,000 COVID+ hospitalized patients in India, showing lower mortality with famotidine and remdesivir in multivariable logistic regression.
Gérard, Zhou, Wu, Kamo, Choi, Kim show significantly increased risk of acute kidney injury with remdesivir.
Remdesivir efficacy disappears with longer followup. Mixed-effects meta-regression of efficacy as a function of followup duration across all remdesivir studies shows decreasing efficacy with longer followup7. This may reflect antiviral efficacy being offset by serious adverse effects of treatment.
Followup duration (days) Efficacy Remdesivir mortality efficacy decreases with longer followup 0 15 30 45 60 75 90 105 -25% 0% 25% 50% c19early.org December 2024 mixed-effects meta-regression slope -0.58 [95% CI -0.92 to -0.24] p=0.00089
Study covers remdesivir and famotidine.
risk of death, 52.9% lower, RR 0.47, p < 0.001, treatment 108 of 413 (26.2%), control 197 of 587 (33.6%), adjusted per study, inverted to make RR<1 favor treatment, odds ratio converted to relative risk, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Siraj et al., 28 Feb 2022, retrospective, India, peer-reviewed, median age 56.0, 13 authors, study period March 2020 - December 2020.
This PaperRemdesivirAll
Medicine ^Assistant Professor ¶ Additional Professor ⇑ Professor Dept. of Rheumatology ψ Professor φ Professor and Head
Dr Farhana Siraj, Nazia Mehfooz, Suhail Mantoo, Afshan Shabir, SYED MUDASIR QADRI ¥ , UMAR HAFIZ £ Tajamul Hussain #, Ajaz Nabi Koul
Background: The outbreak of coronavirus disease 2019 (COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in China, in December 2019, and was declared a pandemic by WHO on March 11, 2020. The treatment is evolving and is mostly supportive in nature. Material and methods: This was a single-center retrospective study that included confirmed COVID-19 cases treated at our institute (a tertiary care hospital in Jammu and Kashmir, India), between March 2020 and December 2020. Patients with age more than 18 years were included in the study. Results: On evaluating the effect of various drug therapies used in management of COVID-19 patients of all severity, use of remdesivir and famotidine was associated with significantly higher odds of survival. In subgroup of patients with severe disease, use of systemic steroids was associated with significantly higher odds of survival in addition to remdesivir and famotidine. In patients with severe COVID-19 illness, likelihood of survival was significantly higher in those who received combination of systemic steroids plus remdesivir compared to steroids and remdesivir alone. Conclusion: Steroids were effective in severe COVID-19 illness and the combination of steroids and remdesivir was more effective in severe illness. There is a need to undertake more large scale prospective randomized trials to determine the most effective drug therapies to treat the sick patients and prevent worsening of mild cases.
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Late treatment
is less effective
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