• Medicina clinica · Aug 2023

    Observational Study

    Remdesivir plus dexamethasone is associated to improve the clinical outcome of COVID-19 hospitalized patients regardless of their vaccination status.

    • Enrique Bernal, Eva García-Villalba, Eduardo Pons, Maria Dolores Hernández, Carlos Báguena, Gabriel Puche, Paula Carter, Mónica Martinez, Antonia Alcaraz, Cristina Tomás, Angeles Muñoz, Maria Rosario Vicente, Maria Luz Nuñez, Natalia Sancho, Mari Carmen Villalba, Alfredo Cano, and Alfredo Minguela.
    • Infectious Disease Unit, Reina Sofia University Hospital and Biomedical Research Institute of Murcia (IMIB), Murcia, Spain. Electronic address: ebm.hgurs@gmail.com.
    • Med Clin (Barc). 2023 Aug 25; 161 (4): 139146139-146.

    IntroductionRemdesivir seems to reduce the risk of hospitalization and improve clinical outcome in hospitalized patients with COVID-19.ObjectivesTo compare the clinical outcome of COVID-19 hospitalized patients treated with remdesivir plus dexamethasone versus dexamethasone alone, according to their vaccination status.Material And MethodsA retrospective observational study was carried out in 165 patients hospitalized for COVID-19 from October 2021 to January 2022. Multivariate logistic regression, Kaplan-Meier and the log-rank tests were used to evaluate the event (need for ventilation or death).ResultsPatients treated with remdesivir plus dexamethasone (n=87) compared with dexamethasone alone (n=78) showed similar age (60±16, 47-70 vs. 62±37, 51-74 years) and number of comorbidities: 1 (0-2) versus 1.5 (1-3). Among 73 fully vaccinated patients, 42 (47.1%) were in remdesivir plus dexamethasone and 31 (41%) in dexamethasone alone. Patients treated with remdesivir plus dexamethasone needed intensive care less frequently (17.2% vs. 31%; p=0.002), high-flow oxygen (25.3% vs. 50.0%; p=0.002) and non-invasive mechanical ventilation (16.1% vs. 47.4%; p<0.001). Furthermore, they had less complications during hospitalization (31.0% vs. 52.6%; p=0.008), need of antibiotics (32.2% vs. 59%; p=0.001) and radiologic worsening (21.8% vs. 44.9%; p=0.005). Treatment with remdesivir plus dexamethasone (aHR, 0.26; 95% CI: 0.14-0.48; p<0.001) and vaccination (aHR 0.39; 95% CI: 0.21-0.74) were independent factors associated with lower progression to mechanical ventilation or death.ConclusionsRemdesivir in combination with dexamethasone and vaccination independently and synergistically protects hospitalized COVID-19 patients requiring oxygen therapy from progression to severe disease or dead.Copyright © 2023 Elsevier España, S.L.U. All rights reserved.

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