Abstract
Introduction
Since the start of the SARS-CoV-2 pandemic, several treatment options have been proposed (e.g. steroids, heparin, antivirals and monoclonal antibodies). Remdesivir was the first antiviral approved for the treatment of COVID-19, even though controversial evidence exists concerning the efficacy. Therefore, we aimed to conduct a study to evaluate whether the use of remdesivir was associated with lower mortality in patients with COVID-19.
Methods
We conducted a nested case–control study of a retrospective cohort collecting medical records of people with SARS-CoV-2 infection admitted in the infectious Disease Unit of Sassari University Hospital (S.C. Clinica di Malattie Infettive, AOU di Sassari, Italy), or in the Infectious Disease Unit of Foggia (AOU “Ospedali Riuniti” Foggia), between 1 July 2020 and 10 November 2021. The outcome considered was death; thus, we matched death (cases) to survivors (controls) by sex and age (1:1).
Results
We included in the study 342 patients, with 171 deaths (cases) and 171 survivors (controls). Remdesivir was administered to 60 people in the control group and to 18 people in the case group (35.1% vs. 10.5%, p < .0001). In the multivariate analysis, treatment with remdesivir and heparin was associated with lower mortality (OR: 0.19 [95% CI :0.10–0.38], p <.0001; OR: 0.39 [95% CI: 0.21–0.74] p = .004, respectively). On the contrary, diabetes, oxygen therapy and CPAP/NIV were associated with higher mortality.
Conclusion
Our study showed lower mortality in people with SARS-CoV-2 infection treated with remdesivir.
Transparency
Declaration of funding
This research has not received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Declaration of financial/other relationships
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Author contributions
Conceptualization: A.D.V., M.P., S.L.C. and G.M. Investigation: A.C., B.Z., T.S., M.C.M., M.F., C.F., A.F. and V.F. Formal analysis: G.S., M.V.P. and L.S. Methodology: A.D,V., M.P., G.S., S.B. and G.M. Validation: A.F. and S.L.C. Visualization: A.C., B.Z., M.F., T.S., M.V.P. and L.S. Resources: C.F. and V.F. Writing – original draft: A.D.V., M.P., A.C., G.S. and G.M. Writing – review and editing: B.Z., M.V.P., T.S., M.C.M., M.F., C.F., L.S., A.F., V.F., S.B. and S.L.C.
Data availability statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.