Remdesivir and hospitalization outcomes in patients with COVID -19 in the period of SARS-CoV-2 Delta circulation
https://doi.org/10.22625/2072-6732-2025-17-2-121-127
Abstract
Aim of the study is to analyze the effect of remdesivir on the outcome of hospitalization in patients with COVID-19 during the period of the SARS-CoV-2 Delta predominance.
Material and methods. Among 11203 patients hospitalized from the pandemics start until June 2023 in the Minsk City Clinical Hospital for Infectious Diseases (Republic of Belarus), 3085 patients admitted during SARS-CoV-2 Delta variant predominance (June 2021 – January 2022). After applying exclusion criteria, the final cohort included 2940 patients, of whom 27,7% (813/2940) received remdesivir. Survival analysis was performed using Cox proportional hazards model, stratified by respiratory failure status at admission. The model included remdesivir and dexamethasone administration, symptom duration, comorbidities, sex, and age as covariates. P-values < 0,05 were considered to be statistically significant. Statistical analysis was performed in R v.4.4.1 with libraries: dplyr, tidyr, survival, survminer, matchit, gtsummary, forplo.
Results. The 28-day survival among patients with remdesivir use and respiratory failure at baseline was 86,5 (79,9-93,6)%, and 91,3 (85,6-97,4)% in patients without respiratory failure. In patients without remdesivir use, the 28-day survival in those with respiratory failure at baseline was 77,9 (69,4-87,5)%, and 85,6 (77,3-94,8)% in patients without respiratory failure. In the Cox proportional hazards model stratified by baseline respiratory failure status, remdesivir use was associated with significantly lower mortality (adjusted HR 0,58, 95% CI 0,39-0,88; p=0,01) after adjustment for sex, age, comorbidities, and dexamethasone administration.
Conclusion. Remdesivir was effective in decreasing inhospital mortality during the predominance of the SARSCoV-2 Delta variant.
About the Authors
D. V. Litvinchuk
Belarusian State Medical University
Belarus
Belarus
Minsk
D. E. Danilov
Belarusian State Medical University
Belarus
Belarus
Minsk
I. A. Karpov
Belarusian State Medical University
Belarus
Belarus
Minsk
References
1. Changing epidemiology of COVID-19: potential future impact on vaccines and vaccination strategies / T. Ulrichs [et al.] // Expert Rev. Vaccines. – 2024. – Т. 23, № 1. – С. 510-522.
2. The evolution of SARS-CoV-2 / P.V. Markov [et al.] // Nat. Rev. Microbiol. – 2023. – Т. 21, № 6. – С. 361-379.
3. Omicron variant of SARS-CoV-2: Genomics, transmissibility, and responses to current COVID-19 vaccines / Y. Araf [et al.] // J. Med. Virol. – 2022. – Т. 94, № 5. – С. 1825-1832.
4. SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness / A. Sheikh [et al.] // Lancet Lond. Engl. – 2021. – Т. 397, № 10293. – С. 2461-2462.
5. Variability in the Clinical Course of COVID-19 in a Retrospective Analysis of a Large Real-World Database / R. Flisiak [et al.] // Viruses. – 2023. – Т. 15, № 1. – С. 149.
6. COVID-19 in Pakistan: A national analysis of five pandemic waves / T. Ahmad [и др.] // PloS One. – 2023. – Т. 18, № 12. – С. e0281326.
7. Brown, C.M. Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings — Barnstable County, Massachusetts, July 2021 / C.M. Brown // MMWR Morb. Mortal. Wkly. Rep. – 2021. – Vol. 70.
8. https://minzdrav.gov.by/ru/sobytiya/indiyskiy-shtamm-COVID-19-vyyavlen-vminske/. – 21.01.2025.
9. Remdesivir for the Treatment of COVID-19 — Final Report / J.H. Beigel [et al.] // N Engl J Med. – 2020 – P. 14.
10. Lamb, Y.N. Remdesivir: First Approval / Y.N. Lamb // Drugs. – 2020. – Vol. 80, № 13. – P. 1355-1363.
11. Lee, T.C. Remdesivir for Coronavirus Disease 2019 in 2024 and Beyond: Checking the Expiry Date of the Milk Carton / T.C. Lee // Clin. Infect. Dis. – 2024 – P. ciae478.
12. An international comparison of age and sex dependency of COVID-19 deaths in 2020: a descriptive analysis / P. Bauer [et al.] // Sci. Rep. – 2021. – Vol. 11, № 1. – P. 19143.
13. COVID-19 and comorbidities: a systematic review and meta-analysis. / Gold M.S. et al. // Postgrad Med. – 2020. – Vol. 132, №8. – P. 749-755.
14. Dexamethasone in Hospitalized Patients with COVID-19 / RECOVERY Collaborative Group et al. // N Engl J Med. – 2021. – Vol. 384, №8. – P. 693-704.
15. WHO Solidarity Trial Consortium. Repurposed Antiviral Drugs for COVID-19 — Interim WHO Solidarity Trial Results / WHO Solidarity Trial Consortium // N. Engl. J. Med. – 2020.
16. Remdesivir treatment in hospitalized patients with COVID-19: a comparative analysis of in-hospital all-cause mortality in a large multi-center observational cohort / E. Mozaffari [et al.] // Clin. Infect. Dis. – 2021 – P. ciab875.
17.
Review
For citations:
Litvinchuk D.V., Danilov D.E., Karpov I.A. Remdesivir and hospitalization outcomes in patients with COVID -19 in the period of SARS-CoV-2 Delta circulation. Journal Infectology. 2025;17(2):121-127. (In Russ.) https://doi.org/10.22625/2072-6732-2025-17-2-121-127
Views:
69
.png)
.png)
Email this article 