Clinical and Virologic Effectiveness of Remdesivir Treatment for Severe Coronavirus Disease 2019 (COVID-19) in Korea: a Nationwide Multicenter Retrospective Cohort Study.

Abstract

BACKGROUND:

Remdesivir is widely used for the treatment of coronavirus disease 2019 (COVID-19), but controversies regarding its efficacy still remain.

METHODS:

A retrospective cohort study was conducted to evaluate the effect of remdesivir on clinical and virologic outcomes of severe COVID-19 patients from June to July 2020. Primary clinical endpoints included clinical recovery, additional mechanical ventilator (MV) support, and duration of oxygen or MV support. Viral load reduction by hospital day (HD) 15 was evaluated by calculating changes in cycle threshold (Ct) values.

RESULTS:

A total of 86 severe COVID-19 patients were evaluated including 48 remdesivir-treated patients. Baseline characteristics were not significantly different between the two groups. Remdesivir was administered an average of 7.42 days from symptom onset. The proportions of clinical recovery of the remdesivir and supportive care group at HD 14 (56.3% and 39.5%) and HD 28 (87.5% and 78.9%) were not statistically different. The proportion of patients requiring MV support by HD 28 was significantly lower in the remdesivir group than in the supportive care group (22.9% vs. 44.7%, P = 0.032), and MV duration was significantly shorter in the remdesivir group (average, 1.97 vs. 5.37 days; P = 0.017). Analysis of upper respiratory tract specimens demonstrated that increases of Ct value from HD 1-5 to 11-15 were significantly greater in the remdesivir group than the supportive care group (average, 10.19 vs. 5.36; P = 0.007), and the slope of the Ct value increase was also significantly steeper in the remdesivir group (average, 5.10 vs. 2.68; P = 0.007).

CONCLUSION:

The remdesivir group showed clinical and virologic benefit in terms of MV requirement and viral load reduction, supporting remdesivir treatment for severe COVID-19.

• Authors: Eun Jeong Joo, Jae Hoon Ko, Seong Eun Kim, Seung Ji Kang, Ji Hyeon Baek, Eun Young Heo, Hye Jin Shi, Joong Sik Eom, Pyoeng Gyun Choe, Seongman Bae, Sang Hyun Ra, Da Young Kim, Baek Nam Kim, Yu Min Kang, Ji Yeon Kim, Jin Won Chung, Hyun Ha Chang, Sohyun Bae, Shinhyea Cheon, Yoonseon Park, Heun Choi, Eunjung Lee, Bo Young Lee, Jung Wan Park, Yujin Sohn, Jung Yeon Heo, Sung Han Kim, Kyong Ran Peck
• Journal: Journal of Korean medical science (J Korean Med Sci) Vol. 36 Issue 11 Pg. e83 (Mar 22 2021) ISSN: 1598-6357 [Electronic] Korea (South)
• PMID: 33754512 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2021 The Korean Academy of Medical Sciences.

Chemical References

• Antiviral Agents
• remdesivir
• Adenosine Monophosphate
• Alanine

Topics

• Adenosine Monophosphate (analogs & derivatives, therapeutic use)
• Aged
• Aged, 80 and over
• Alanine (analogs & derivatives, therapeutic use)
• Antiviral Agents (therapeutic use)
• COVID-19 (virology)
• Female
• Humans
• Male
• Middle Aged
• Real-Time Polymerase Chain Reaction
• Respiration, Artificial
• Retrospective Studies
• SARS-CoV-2
• Viral Load
• COVID-19 Drug Treatment