Evaluation of the effectiveness of remdesivir in severe COVID-19 using observational data from a prospective national cohort study



Arch, BN ORCID: 0000-0001-6060-8091, Kovacs, D, Scott, JT, Jones, AP, Harrison, EM, Rosala-Hallas, A ORCID: 0000-0001-8012-9995, Gamble, CG, Openshaw, PJM ORCID: 0000-0002-7220-2555, Baillie, JK ORCID: 0000-0001-5258-793X and Semple, MG
(2021) Evaluation of the effectiveness of remdesivir in severe COVID-19 using observational data from a prospective national cohort study. [Preprint]

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Abstract

<h4>Background</h4> Remdesivir has been evaluated in clinical trial populations, but there is a sparsity of evidence evaluating effectiveness in general populations. <h4>Methods</h4> Adults eligible to be treated with remdesivir, requiring oxygen but not ventilated, were identified from UK patients hospitalised with COVID-19. Patients treated with remdesivir within 24h of hospitalisation were compared with propensity-score matched controls; estimates of effectiveness were calculated for short-term outcomes (14-day mortality, 28-day mortality, time-to-recovery among others) using multivariable modelling. <h4>Results</h4> 9,278 out of 39,330 patients satisfied eligibility criteria. 1,549 patients were identified as ‘treated’ and matched with 4,964 controls. Patients were 62% male, mean (SD) age 63.1 (15.6) years, 80% ‘White’ ethnicity, and symptomatic for a median of 6 days prior to baseline. There was no statistically significant benefit of remdesivir at 14 days in terms of mortality or clinical status; there were signals of effectiveness in time-to-recovery after day 9, and a reduction in 28-day mortality. <h4>Conclusion</h4> In a real-world setting, initiation of remdesivir within 24h of hospitalisation in conjunction with standard of care was not associated with a benefit at 14 days but supports clinical trial evidence of a potential reduction in 28-day mortality.

Item Type: Preprint
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Clinical Directorate
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 24 Jun 2021 08:01
Last Modified: 06 Oct 2022 06:17
DOI: 10.1101/2021.06.18.21259072
Open Access URL: https://www.medrxiv.org/content/10.1101/2021.06.18...
URI: https://livrepository.liverpool.ac.uk/id/eprint/3127439