Effects of Remdesivir on in-Hospital and Late Outcomes of Patients With Confirmed or Clinically Suspected COVID-19: A Propensity Score-Matched Study

Abstract

Remdesivir, an antiviral medication, became an early promising therapeutic candidate for coronavirus disease 2019 (COVID-19) due to its ability to inhibit the virus in vitro. Current evidence about remdesivir treatment has been very controversial, so we aim to evaluate remdesivir to improve our knowledge about COVID-19 management and its long-term effects. In this retrospective cohort study using registered data derived from the Sina Hospital COVID-19 Registry with a 9-month follow-up, we enrolled patients receiving remdesivir and then matched a "control group" which did not receive remdesivir based on age, gender, and severity using propensity score matching. We used multivariant Cox regression to evaluate the remdesivir effect on patients' 9-month and in-hospital survival. We enrolled 227 patients, 116 in remdesivir and 111 in the control group. 213(93.8%) patients developed the severe disease, 88(38.8%) died during the 9-month follow-up, and 84(37.0%) died during hospitalization. In multivariate analysis, remdesivir did not affect the 9-month all-cause mortality and in-hospital mortality. Remdesivir was associated with increased in-hospital survival only in severe patients with diabetes (HR: 0.32; 95% CI: 0.14-0.75; P:0.008), and there was a trend for better 9-month survival in severe patients with diabetes (HR: 0.47; 95% CI: 0.20-1.09; P:0.080). We concluded that remdesivir treatment did not increase the 9-month survival rate either in patients with COVID-19 or patients with severe disease and underlying diseases. On the other hand, we found that remdesivir treatment could increase in-hospital survival only in patients with severe COVID-19 and a history of diabetes mellitus.

Keywords

• Coronavirus disease 2019 (COVID-19)
• Cox regression
• Propensity score matching
• Remdesivir
• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)