Effect of remdesivir on mortality and the need for mechanical ventilation among hospitalized patients with COVID-19: real-world data from a resource-limited country

• Published in: International journal of infectious diseases 2023-04, Vol.129, p.63-69
• Main Authors: Metchurtchlishvili, Revaz, Chkhartishvili, Nikoloz, Abutidze, Akaki, Endeladze, Marina, Ezugbaia, Marine, Bakradze, Ana, Tsertsvadze, Tengiz
• Format: Article
• Language: English
• Subjects: Alanine - therapeutic use; Antiviral Agents - therapeutic use; COVID-19; COVID-19 - therapy; COVID-19 Drug Treatment; Eastern Europe; Georgia; Humans; Inpatients; Mechanical Ventilation; Mortality; Remdesivir; Respiration, Artificial
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2023.01.021

•Propensity score-matched cohort study of remdesivir in patients with COVID-19.•Remdesivir showed borderline significant mortality benefit in a multivariable model.•Remdesivir significantly reduced the new need for mechanical ventilation.•The study supports routine use of remdesivir in hospitalized patients with COVID-19. Georgia introduced remdesivir for the treatment of COVID-19 in December 2020. We evaluated the real-world effect of remdesivir on mortality and the need for mechanical ventilation among inpatients with COVID-19. The study included 346 remdesivir recipients and 346 controls not receiving remdesivir selected through propensity score matching based on age, gender, presence of any chronic comorbid condition, and oxygen saturation at admission. Factors associated with in-hospital mortality and the need for mechanical ventilation were assessed in a multivariable logistic regression model. The groups were comparable by age, gender, comorbidities, and baseline oxygen saturation. Among 346 remdesivir recipients, 265 (76.6%) received a generic formulation of the drug. Eight (2.3%) patients died in the remdesivir group and 18 (5.2%) in the control group (P = 0.046). In the multivariable analysis, remdesivir was associated with non-statistically significant reduced odds of death (odds ratio: 0.39, 95% confidence interval: 0.14-1.04, P = 0.06). Significantly fewer patients in the remdesivir group required mechanical ventilation compared to controls: 2.9% vs 6.4% (P = 0.03). Statistically significant difference was maintained in multivariable analysis (odds ratio: 0.40, 95% confidence interval: 1.04-5.60, P = 0.04). Borderline reduction in the odds of death and statistically significant decrease in the need for mechanical ventilation support use of remdesivir in hospitalized patients with COVID-19.