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0 0.5 1 1.5 2+ Mortality -4% Improvement Relative Risk Mechanical ventilation or.. 2% Progression 15% Remdesivir  Tsuzuki et al.  LATE TREATMENT Is late treatment with remdesivir beneficial for COVID-19? Retrospective 12,487 patients in Japan No significant difference in outcomes seen Tsuzuki et al., Int. J. Infectious Dis.., Mar 2021 Favors remdesivir Favors control

Efficacy of remdesivir in hospitalized nonsevere COVID-19 patients in Japan: A large observational study using the COVID-19 Registry Japan

Tsuzuki et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.02.039 (date from preprint)
Mar 2021  
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Retrospective database analysis of 12,487 hospitalized patients in Japan, showing lower risk of oxygen requirement, but no significant difference in mortality or ventilation/ECMO.
Gérard, Wu, Zhou show significantly increased risk of acute kidney injury with remdesivir.
risk of death, 4.0% higher, HR 1.04, p = 0.21, treatment 69 of 824 (8.4%), control 285 of 11,663 (2.4%), adjusted per study, day 30.
risk of mechanical ventilation or ECMO, 1.7% lower, HR 0.98, p = 0.68, treatment 48 of 824 (5.8%), control 98 of 11,663 (0.8%), adjusted per study.
risk of progression, 15.0% lower, HR 0.85, p = 0.68, treatment 559 of 824 (67.8%), control 1,784 of 11,663 (15.3%), adjusted per study.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Tsuzuki et al., 10 Mar 2021, retrospective, Japan, peer-reviewed, 21 authors, average treatment delay 6.0 days.
This PaperRemdesivirAll
Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan
Shinya Tsuzuki, Kayoko Hayakawa, Yukari Uemura, Tomohiro Shinozaki, Nobuaki Matsunaga, Mari Terada, Setsuko Suzuki, Yusuke Asai, Koji Kitajima, Sho Saito, Gen Yamada, Taro Shibata, Masashi Kondo, Kazuo Izumi, Masayuki Hojo, Tetsuya Mizoue, Kazuhisa Yokota, Fukumi Nakamura-Uchiyama, Fumitake Saito, Wataru Sugiura, Norio Ohmagari
International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.02.039
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Ethics This study was approved by the NCGM ethics review (NCGM-G-003494-0). Information regarding opting out of our study is available on the registry website. Declaration of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:
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Late treatment
is less effective
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