Time from symptoms onset to remdesivir is associated with the risk of ICU admission: a multicentric analyses

Shorter duration of symptoms before remdesivir has been associated with better outcomes. Our goal was to evaluate variables associated with the need of ICU admission in a cohort of hospitalized patients for COVID-19 under remdesivir including the period from symptoms onset to remdesivir. We conducte...

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Detalhes bibliográficos
Autores: Alonso-Navarro, Rodrigo, Ramirez, Margarita, Masiá, Mar, Paredes, Roger, Montejano, Rocío, Povar-Echeverria, Marina, Carratalà, Jordi, Salavert Lleti, Miguel, Bernal, Enrique, Duenas, Carlos, Flores, Juan, Fanjul, Francisco, Gutiérrez, Isabel, Rico, Verónica, Mateu, Lourdes, Cadiñanos, Julen, Berenguer, Juan, Soriano, Alex
Tipo de documento: artigo
Data de publicação:2023
País:España
Recursos:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositório:Docusalut
Idioma:inglês
OAI Identifier:oai:docusalut.com:20.500.13003/18979
Acesso em linha:https://hdl.handle.net/20.500.13003/18979
Access Level:Acceso aberto
Palavra-chave:Intensive Care Units
SARS-CoV-2
Humans
COVID-19
Retrospective Studies
Humanos
Estudios Retrospectivos
Unidades de Cuidados Intensivos
Descrição
Resumo:Shorter duration of symptoms before remdesivir has been associated with better outcomes. Our goal was to evaluate variables associated with the need of ICU admission in a cohort of hospitalized patients for COVID-19 under remdesivir including the period from symptoms onset to remdesivir. We conducted a retrospective multicentric study analysing all patients admitted with COVID-19 in 9 Spanish hospitals who received treatment with remdesivir in October 2020. The main outcome was the need of ICU admission after 24 h of the first dose of remdesivir. In our cohort of 497 patients, the median of days from symptom onset to remdesivir was 5 days, and 70 of them (14.1%) were later admitted into ICU. The clinical outcomes associated with ICU admission were days from symptoms onset (5 vs. 6; p = 0.023), clinical signs of severe disease (respiratory rate, neutrophil count, ferritin levels and very-high mortality rate in SEIMC-Score) and the use of corticosteroids and anti-inflammatory drugs before ICU. The only variable significatively associated with risk reduction in the Cox-regression analyses was ≤ 5 days from symptoms onset to RDV (HR: 0.54, CI95%: 0.31-0.92; p = 0.024). For patients admitted to the hospital with COVID-19, the prescription of remdesivir within 5 days from symptoms onset diminishes the need of ICU admission.

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