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Clinical evolution and mortality of critically ill patients with SARS-CoV-2 pneumonia treated with remdesivir in an adult intensive care unit of Paraguay
The health crisis due to Covid-19 led to the search for therapeutics that could improve the evolution of the disease. Remdesivir, an antiviral that interferes with viral replication, was one of the first to be used for the treatment of this pathology. To determine clinical course and mortality of pa...
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| Published in: | BMC infectious diseases 2024-01, Vol.24 (1), p.37-37, Article 37 |
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| creator | Figueredo, Jessica Lopez, Lorena Fontclara Leguizamon, Belinda Figueredo Samudio, Margarita Pederzani, Marcelo Apelt, Federico Fretes Añazco, Patricia Caballero, Ricardo Bianco, Hugo |
| description | The health crisis due to Covid-19 led to the search for therapeutics that could improve the evolution of the disease. Remdesivir, an antiviral that interferes with viral replication, was one of the first to be used for the treatment of this pathology.
To determine clinical course and mortality of patients with severe SARS-CoV-2 pneumonia treated with remdesivir, in comparison of those who didn't receive the medication.
Retrospective cohort study, with medical records review of COVID-19 patients, between August 2020 and August 2021. The subjects were divided into two groups, those who received remdesivir before or after admission to intensive care and those who didn't. The primary outcome variable was mortality in intensive care.
Of 214 subjects included, 109 (50,9%) received remdesivir. The median of days for the drug administration was 8 (2-20), IQR: 3. The bivariate analysis prove that the use of remdesivir was related with lower risk of develop Acute Respiratory Distress Syndrome (ARDS) (p = 0,019; OR: 0,521) and lower requirement of mechanical ventilation (p = 0,006; OR:0,450). Additionally, patients treated with remdesivir develop less kidney injury (p = 0,009; OR: 0,441). There was a total of 82 deaths, 29 (26,6%) in the remdesivir group and 53 (50,5%) in the control group [p |
| doi_str_mv | 10.1186/s12879-023-08917-2 |
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To determine clinical course and mortality of patients with severe SARS-CoV-2 pneumonia treated with remdesivir, in comparison of those who didn't receive the medication.
Retrospective cohort study, with medical records review of COVID-19 patients, between August 2020 and August 2021. The subjects were divided into two groups, those who received remdesivir before or after admission to intensive care and those who didn't. The primary outcome variable was mortality in intensive care.
Of 214 subjects included, 109 (50,9%) received remdesivir. The median of days for the drug administration was 8 (2-20), IQR: 3. The bivariate analysis prove that the use of remdesivir was related with lower risk of develop Acute Respiratory Distress Syndrome (ARDS) (p = 0,019; OR: 0,521) and lower requirement of mechanical ventilation (p = 0,006; OR:0,450). Additionally, patients treated with remdesivir develop less kidney injury (p = 0,009; OR: 0,441). There was a total of 82 deaths, 29 (26,6%) in the remdesivir group and 53 (50,5%) in the control group [p < 0,001; OR: 0,356 (0,201-0,630)]. All the risk factors associated with mortality in the bivariate analysis were entered into the multivariate analysis by logistic regression, the use of remdesivir remained associated as an independent protective factor to mortality (p = 0.034; OR: 0.429).
Critically ill patients with SARS-CoV-2 pneumonia treated with remdesivir had a lower risk of death and need for mechanical ventilation and develop less ARDS as compared to the control group. No differences were found in the presentation of adverse effects.</description><identifier>ISSN: 1471-2334</identifier><identifier>EISSN: 1471-2334</identifier><identifier>DOI: 10.1186/s12879-023-08917-2</identifier><identifier>PMID: 38166777</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Acute respiratory distress syndrome ; Antiviral drugs ; ARDS ; Bacterial pneumonia ; Bivariate analysis ; Causes of ; Comparative analysis ; COVID-19 ; Critically ill ; Demographic aspects ; Diagnosis ; Drug therapy ; Evolution ; Hemodialysis ; Homeopathy ; Hospitals ; Illnesses ; Intensive care ; Kidneys ; Materia medica and therapeutics ; Mechanical ventilation ; Medical records ; Medical research ; Medicine, Experimental ; Mortality ; Multivariate analysis ; Pandemics ; Paraguay ; Patient outcomes ; Patients ; Pneumonia ; Regression analysis ; Remdesivir ; Risk factors ; RNA polymerase ; Severe acute respiratory syndrome coronavirus 2 ; Steroids ; Therapeutics ; United Kingdom ; Variables ; Ventilation ; Ventilators ; Viral diseases</subject><ispartof>BMC infectious diseases, 2024-01, Vol.24 (1), p.37-37, Article 37</ispartof><rights>2023. The Author(s).</rights><rights>COPYRIGHT 2024 BioMed Central Ltd.</rights><rights>2024. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c632t-d770f7ff81c2bf59fa449017d1deee9cdec3d58f32e3f26f905af192a101cff23</citedby><cites>FETCH-LOGICAL-c632t-d770f7ff81c2bf59fa449017d1deee9cdec3d58f32e3f26f905af192a101cff23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10762832/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2914277032?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25732,27903,27904,36991,36992,38495,43874,44569,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38166777$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Figueredo, Jessica</creatorcontrib><creatorcontrib>Lopez, Lorena Fontclara</creatorcontrib><creatorcontrib>Leguizamon, Belinda Figueredo</creatorcontrib><creatorcontrib>Samudio, Margarita</creatorcontrib><creatorcontrib>Pederzani, Marcelo</creatorcontrib><creatorcontrib>Apelt, Federico Fretes</creatorcontrib><creatorcontrib>Añazco, Patricia</creatorcontrib><creatorcontrib>Caballero, Ricardo</creatorcontrib><creatorcontrib>Bianco, Hugo</creatorcontrib><title>Clinical evolution and mortality of critically ill patients with SARS-CoV-2 pneumonia treated with remdesivir in an adult intensive care unit of Paraguay</title><title>BMC infectious diseases</title><addtitle>BMC Infect Dis</addtitle><description>The health crisis due to Covid-19 led to the search for therapeutics that could improve the evolution of the disease. Remdesivir, an antiviral that interferes with viral replication, was one of the first to be used for the treatment of this pathology.
To determine clinical course and mortality of patients with severe SARS-CoV-2 pneumonia treated with remdesivir, in comparison of those who didn't receive the medication.
Retrospective cohort study, with medical records review of COVID-19 patients, between August 2020 and August 2021. The subjects were divided into two groups, those who received remdesivir before or after admission to intensive care and those who didn't. The primary outcome variable was mortality in intensive care.
Of 214 subjects included, 109 (50,9%) received remdesivir. The median of days for the drug administration was 8 (2-20), IQR: 3. The bivariate analysis prove that the use of remdesivir was related with lower risk of develop Acute Respiratory Distress Syndrome (ARDS) (p = 0,019; OR: 0,521) and lower requirement of mechanical ventilation (p = 0,006; OR:0,450). Additionally, patients treated with remdesivir develop less kidney injury (p = 0,009; OR: 0,441). There was a total of 82 deaths, 29 (26,6%) in the remdesivir group and 53 (50,5%) in the control group [p < 0,001; OR: 0,356 (0,201-0,630)]. All the risk factors associated with mortality in the bivariate analysis were entered into the multivariate analysis by logistic regression, the use of remdesivir remained associated as an independent protective factor to mortality (p = 0.034; OR: 0.429).
Critically ill patients with SARS-CoV-2 pneumonia treated with remdesivir had a lower risk of death and need for mechanical ventilation and develop less ARDS as compared to the control group. No differences were found in the presentation of adverse effects.</description><subject>Acute respiratory distress syndrome</subject><subject>Antiviral drugs</subject><subject>ARDS</subject><subject>Bacterial pneumonia</subject><subject>Bivariate analysis</subject><subject>Causes of</subject><subject>Comparative analysis</subject><subject>COVID-19</subject><subject>Critically ill</subject><subject>Demographic aspects</subject><subject>Diagnosis</subject><subject>Drug therapy</subject><subject>Evolution</subject><subject>Hemodialysis</subject><subject>Homeopathy</subject><subject>Hospitals</subject><subject>Illnesses</subject><subject>Intensive care</subject><subject>Kidneys</subject><subject>Materia medica and therapeutics</subject><subject>Mechanical ventilation</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Pandemics</subject><subject>Paraguay</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Regression analysis</subject><subject>Remdesivir</subject><subject>Risk factors</subject><subject>RNA polymerase</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Steroids</subject><subject>Therapeutics</subject><subject>United Kingdom</subject><subject>Variables</subject><subject>Ventilation</subject><subject>Ventilators</subject><subject>Viral 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Paraguay</title><author>Figueredo, Jessica ; Lopez, Lorena Fontclara ; Leguizamon, Belinda Figueredo ; Samudio, Margarita ; Pederzani, Marcelo ; Apelt, Federico Fretes ; Añazco, Patricia ; Caballero, Ricardo ; Bianco, Hugo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c632t-d770f7ff81c2bf59fa449017d1deee9cdec3d58f32e3f26f905af192a101cff23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acute respiratory distress syndrome</topic><topic>Antiviral drugs</topic><topic>ARDS</topic><topic>Bacterial pneumonia</topic><topic>Bivariate analysis</topic><topic>Causes of</topic><topic>Comparative analysis</topic><topic>COVID-19</topic><topic>Critically ill</topic><topic>Demographic aspects</topic><topic>Diagnosis</topic><topic>Drug therapy</topic><topic>Evolution</topic><topic>Hemodialysis</topic><topic>Homeopathy</topic><topic>Hospitals</topic><topic>Illnesses</topic><topic>Intensive care</topic><topic>Kidneys</topic><topic>Materia medica and therapeutics</topic><topic>Mechanical ventilation</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Pandemics</topic><topic>Paraguay</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Pneumonia</topic><topic>Regression analysis</topic><topic>Remdesivir</topic><topic>Risk factors</topic><topic>RNA polymerase</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Steroids</topic><topic>Therapeutics</topic><topic>United Kingdom</topic><topic>Variables</topic><topic>Ventilation</topic><topic>Ventilators</topic><topic>Viral 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Jessica</au><au>Lopez, Lorena Fontclara</au><au>Leguizamon, Belinda Figueredo</au><au>Samudio, Margarita</au><au>Pederzani, Marcelo</au><au>Apelt, Federico Fretes</au><au>Añazco, Patricia</au><au>Caballero, Ricardo</au><au>Bianco, Hugo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical evolution and mortality of critically ill patients with SARS-CoV-2 pneumonia treated with remdesivir in an adult intensive care unit of Paraguay</atitle><jtitle>BMC infectious diseases</jtitle><addtitle>BMC Infect Dis</addtitle><date>2024-01-02</date><risdate>2024</risdate><volume>24</volume><issue>1</issue><spage>37</spage><epage>37</epage><pages>37-37</pages><artnum>37</artnum><issn>1471-2334</issn><eissn>1471-2334</eissn><abstract>The health crisis due to Covid-19 led to the search for therapeutics that could improve the evolution of the disease. Remdesivir, an antiviral that interferes with viral replication, was one of the first to be used for the treatment of this pathology.
To determine clinical course and mortality of patients with severe SARS-CoV-2 pneumonia treated with remdesivir, in comparison of those who didn't receive the medication.
Retrospective cohort study, with medical records review of COVID-19 patients, between August 2020 and August 2021. The subjects were divided into two groups, those who received remdesivir before or after admission to intensive care and those who didn't. The primary outcome variable was mortality in intensive care.
Of 214 subjects included, 109 (50,9%) received remdesivir. The median of days for the drug administration was 8 (2-20), IQR: 3. The bivariate analysis prove that the use of remdesivir was related with lower risk of develop Acute Respiratory Distress Syndrome (ARDS) (p = 0,019; OR: 0,521) and lower requirement of mechanical ventilation (p = 0,006; OR:0,450). Additionally, patients treated with remdesivir develop less kidney injury (p = 0,009; OR: 0,441). There was a total of 82 deaths, 29 (26,6%) in the remdesivir group and 53 (50,5%) in the control group [p < 0,001; OR: 0,356 (0,201-0,630)]. All the risk factors associated with mortality in the bivariate analysis were entered into the multivariate analysis by logistic regression, the use of remdesivir remained associated as an independent protective factor to mortality (p = 0.034; OR: 0.429).
Critically ill patients with SARS-CoV-2 pneumonia treated with remdesivir had a lower risk of death and need for mechanical ventilation and develop less ARDS as compared to the control group. No differences were found in the presentation of adverse effects.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>38166777</pmid><doi>10.1186/s12879-023-08917-2</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1471-2334 |
| ispartof | BMC infectious diseases, 2024-01, Vol.24 (1), p.37-37, Article 37 |
| issn | 1471-2334 1471-2334 |
| language | eng |
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| source | Publicly Available Content Database (Proquest) (PQ_SDU_P3); PubMed Central; Coronavirus Research Database |
| subjects | Acute respiratory distress syndrome Antiviral drugs ARDS Bacterial pneumonia Bivariate analysis Causes of Comparative analysis COVID-19 Critically ill Demographic aspects Diagnosis Drug therapy Evolution Hemodialysis Homeopathy Hospitals Illnesses Intensive care Kidneys Materia medica and therapeutics Mechanical ventilation Medical records Medical research Medicine, Experimental Mortality Multivariate analysis Pandemics Paraguay Patient outcomes Patients Pneumonia Regression analysis Remdesivir Risk factors RNA polymerase Severe acute respiratory syndrome coronavirus 2 Steroids Therapeutics United Kingdom Variables Ventilation Ventilators Viral diseases |
| title | Clinical evolution and mortality of critically ill patients with SARS-CoV-2 pneumonia treated with remdesivir in an adult intensive care unit of Paraguay |
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