Remdesivir and corticosteroids in the treatment of hospitalized COVID-19 patients

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作者
Luís Coelho
Fatima Falcão
Pedro Póvoa
Erica Viegas
Antonio Pais Martins
Eduarda Carmo
Candida Fonseca
Luis Campos
Kamal Mansinho
Inês Carmo
Joana Soares
Mariana Solano
Dina Mendes
Ana Cláudia Miranda
Antonio Carvalho
Ana Mirco
Helena Farinha
Isabel Aldir
José Correia
机构
[1] Hospital de São Francisco Xavier,Polyvalent Intensive Care Unit
[2] Centro Hospitalar de Lisboa Ocidental,NOVA Medical School, CHRC
[3] New University of Lisbon,Pharmacy Department
[4] Centro Hospitalar de Lisboa Ocidental,Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology
[5] Faculty of Pharmacy of the University of Lisbon,Surgical Intensive Care Unit
[6] OUH Odense University Hospital,Polyvalent Intensive Care Unit
[7] Hospital de S. Francisco Xavier,Internal Medicine
[8] Centro Hospitalar de Lisboa Ocidental,Infecciology
[9] Hospital de Egas Moniz,Pharmacy and Therapeutics Committee
[10] Centro Hospitalar de Lisboa Ocidental,undefined
[11] Hospital de S. Francisco Xavier,undefined
[12] Centro Hospitalar de Lisboa Ocidental,undefined
[13] Hospital de Egas Moniz,undefined
[14] Centro Hospitalar de Lisboa Ocidental,undefined
[15] Centro Hospitalar de Lisboa Ocidental,undefined
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摘要
Coronavirus disease 2019 (COVID-19) is a pandemic infection caused by the newly discovered severe acute respiratory syndrome coronavirus 2. Remdesivir (RDV) and corticosteroids are used mainly in COVID-19 patients with acute respiratory failure. The main objective of the study was to assess the effectiveness of remdesivir with and without corticosteroids in the treatment of COVID-19 patients. We conducted a prospective observational study, including adult patients consecutively hospitalized with confirmed COVID-19 and acute respiratory failure. Patients were divided according to treatment strategy: RDV alone versus RDV with corticosteroids. The primary outcome was the time to recovery in both treatment groups. We included 374 COVID-19 adult patients, 184 were treated with RDV, and 190 were treated with RDV and corticosteroid. Patients in the RDV group had a shorter time to recovery in comparison with patients in the RDV plus corticosteroids group at 28 days after admission [11 vs. 16 days (95% confidence Interval 9.7–12.8; 14.9–17.1; p = .016)]. Patients treated with RDV alone had a shorter length of hospital stay. The use of corticosteroids as adjunctive therapy of RDV was not associated with improvement in mortality of COVID-19 patients.
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