A COMPREHENSIVE INVESTIGATION INTO THE INFLUENCE OF REMDESIVIR ON MORTALITY AND MORBIDITY AMONG INDIVIDUALS AFFLICTED WITH COVID-19: RETROSPECTIVE COHORT STUDY
Main Article Content
Keywords
COVID-19, Remdesivir, morbidity, mortality
Abstract
Background: Remdesivir’s distinct method of action is a promising strategy for battling viral illnesses. It assists in lowering the viral load and reducing the severity and length of infection by interfering with the replication mechanism of the virus.
Methodology: Retrospective cohort study was conducted at a tertiary care hospital in AJK, Pakistan. The data was collected from hospital records and the analysis was performed to find the effectiveness of Remdesivir.
Results: There were 62.7% males and 37.3% females and the most common symptoms were fever, cough and shortness of breath. Remdesivir was initiated early in 126 patients. The mean number of doses is 2.0 and Remdesivir affects the recovery (p<0.05).
Conclusion: Remdesivir can be administered in COVID-19 patients but the results from past are mix. Remdesivir has good therapeutic efficacy.
References
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39. Hidalgo-Tenorio C, García-Vallecillos C, Sequera-Arquelladas S. Real-world outcomes of COVID-19 treatment with remdesivir in a Spanish hospital. Medicine (Baltimore) [Internet]. 2021;100(37). Available from: https://journals.lww.com/md-journal/Fulltext/2021/09170/Real_world_outcomes_of_COVID_19_treatment_with.38.aspx
40. Tiseo G, Barbieri C, Galfo V, Occhineri S, Matucci T, Almerigogna F, et al. Efficacy and Safety of Nirmatrelvir/Ritonavir, Molnupiravir, and Remdesivir in a Real-World Cohort of Outpatients with COVID-19 at High Risk of Progression: The PISA Outpatient Clinic Experience. Infect Dis Ther [Internet]. 2023;12(1):257–71. Available from: https://doi.org/10.1007/s40121-022-00729-2
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2. Brown AJ, Won JJ, Graham RL, Dinnon KH, Sims AC, Feng JY, et al. Broad spectrum antiviral remdesivir inhibits human endemic and zoonotic deltacoronaviruses with a highly divergent RNA dependent RNA polymerase. Antiviral Res [Internet]. 2019;169:104541. Available from: https://www.sciencedirect.com/science/article/pii/S0166354219300993
3. Eli Lilly Company. HIGHLIGHTS OF PRESCRIBING INFORMATION [Internet]. 1996 [cited 2023 Aug 20]. Available from: www.fda.gov/medwatch.
4. European Medicines Agency. Background review for cyclodextrins used as excipients In the context of the revision of the guideline on “Excipients in the label.” 2014;44(November):12–6. Available from: www.ema.europa.eu/contact
5. Adamsick ML, Gandhi RG, Bidell MR, Elshaboury RH, Bhattacharyya RP, Kim AY, et al. Remdesivir in Patients with Acute or Chronic Kidney Disease and COVID-19. J Am Soc Nephrol. 2020 Jul;31(7):1384–6.
6. Cao Y, Deng Q, Dai S. Remdesivir for severe acute respiratory syndrome coronavirus 2 causing COVID-19: An evaluation of the evidence. Travel Med Infect Dis [Internet]. 2020;35:101647.Available from: https://www.sciencedirect.com/science/article/pii/S1477893920301162
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8. Siemieniuk RAC, Bartoszko JJ, Zeraatkar D, Kum E, Qasim A, D\’\iaz Martinez JP, et al. Drug treatments for covid-19: living systematic review and network meta-analysis. BMJ [Internet]. 2020;370. Available from: https://www.bmj.com/content/370/bmj.m2980
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11. Li Z, Wang X, Cao D, Sun R, Li C, Li G. Rapid review for the anti-coronavirus effect of remdesivir. Drug Discov Ther. 2020;14(2):73–6.
12. Mohanty B, Sunder A, Satyanarayan B, Kumar M, Shukla R, Ahmed A. Success rate of Remdesivir, Convalescent Plasma, and Tocilizumab in moderate to severe Covid-19 pneumonia: our experience in a tertiary care center. J Fam Med Prim Care [Internet]. 2021;10(11). Available from: https://journals.lww.com/jfmpc/Fulltext/2021/11000/Success_rate_of_Remdesivir,_Convalescent_Plasma,.47.aspx
13. Young B, Tan TT, Leo YS. The place for remdesivir in COVID-19 treatment. Lancet Infect Dis [Internet]. 2021;21(1):20–1. Available from: http://dx.doi.org/10.1016/S1473-3099(20)30911-7
14. Jo Y, Jamieson L, Edoka I, Long L, Silal S, Pulliam JRC, et al. Cost-effectiveness of Remdesivir and Dexamethasone for COVID-19 Treatment in South Africa. Open Forum Infect Dis [Internet]. 2021 Mar 1;8(3):ofab040. Available from: https://doi.org/10.1093/ofid/ofab040
15. Sheahan TP, Sims AC, Leist SR, Schäfer A, Won J, Brown AJ, et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun [Internet]. 2020;11(1):222. Available from: https://doi.org/10.1038/s41467-019-13940-6
16. Simonis A, Theobald SJ, Fätkenheuer G, Rybniker J, Malin JJ. A comparative analysis of remdesivir and other repurposed antivirals against SARS-CoV-2. EMBO Mol Med [Internet]. 2021 Jan 11;13(1):e13105. Available from: https://doi.org/10.15252/emmm.202013105
17. Vitiello A, Ferrara F, Porta R La. Remdesivir and COVID-19 infection, therapeutic benefits or unnecessary risks? Irish J Med Sci (1971 -) [Internet]. 2021;190(4):1637–8. Available from: https://doi.org/10.1007/s11845-020-02482-2
18. Caffrey AR, Liao JX, Lopes V V., LaPlante KL, Appaneal HJ. Real-World Safety and Effectiveness of Remdesivir and Corticosteroids in Hospitalized Patients with COVID-19. Covid. 2023;3(2):198–217.
19. Alegre-Del Rey EJ, Gil-Sierra MD, Alarcón de la Lastra-Romero C, Sánchez-Hidalgo M. Remdesivir y reducción de mortalidad en pacientes con COVID-19: análisis sistematizado de subgrupos de los ensayos clínicos. Farm Hosp. 2021;45(1):28–31.
20. Grein J, Ohmagari N, Shin D, Diaz G, Asperges E, Castagna A, et al. Compassionate Use of Remdesivir for Patients with Severe Covid-19. N Engl J Med. 2020;382(24):2327–36.
21. Spinner CD, Gottlieb RL, Criner GJ, Arribas López JR, Cattelan AM, Soriano Viladomiu A, et al. Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderate COVID-19: A Randomized Clinical Trial. JAMA [Internet]. 2020 Sep 15;324(11):1048–57. Available from: https://doi.org/10.1001/jama.2020.16349
22. Hillaker E, Belfer JJ, Bondici A, Murad H, Dumkow LE. Delayed Initiation of Remdesivir in a COVID-19-Positive Patient. Pharmacother J Hum Pharmacol Drug Ther [Internet]. 2020 Jun 1;40(6):592–8. Available from: https://doi.org/10.1002/phar.2403
23. Mahendra M, Nuchin A, Kumar R, Shreedhar S, Mahesh PA. Predictors of mortality in patients with severe COVID-19 pneumonia — a retrospective study. Adv Respir Med [Internet]. 2021;89(2):135–44. Available from: https://doi.org/10.5603/ARM.a2021.0036
24. Singh AK, Singh A, Singh R, Misra A. Remdesivir in COVID-19: A critical review of pharmacology, pre-clinical and clinical studies. Diabetes Metab Syndr Clin Res Rev [Internet]. 2020;14(4):641–8. Available from: https://www.sciencedirect.com/science/article/pii/S1871402120301375
25. Nichols BE, Jamieson L, Zhang SRC, Rao GA, Silal S, Pulliam JRC, et al. The Role of Remdesivir in South Africa: Preventing COVID-19 Deaths Through Increasing Intensive Care Unit Capacity. Clin Infect Dis [Internet]. 2021 May 1;72(9):1642–4. Available from: https://doi.org/10.1093/cid/ciaa937
26. Mastruzzo C, Commodari E, Grasso U, La Rosa VL, Balsamo D, Circo C, et al. Early Stage Combination Treatment with Methylprednisolone Pulse and Remdesivir for Severe COVID-19 Pneumonia. Vol. 20, International Journal of Environmental Research and Public Health. 2023.
27. Tasavon Gholamhoseini M, Yazdi-Feyzabadi V, Goudarzi R, Mehrolhassani MH. Safety and Efficacy of Remdesivir for the Treatment of COVID-19: A Systematic Review and Meta-Analysis . J Pharm Pharm Sci [Internet]. 2021 May 17;24(SE-Systematic Review and Meta-Analysis):237–45. Available from: https://journals.library.ualberta.ca/jpps/index.php/JPPS/article/view/31870
28. J. MJ, Isabelle S, Vanessa P, Gerd F, Jan R. Remdesivir against COVID-19 and Other Viral Diseases. Clin Microbiol Rev [Internet]. 2020 Oct 14;34(1):10.1128/cmr.00162-20. Available from: https://doi.org/10.1128/cmr.00162-20
29. Arch BN, Kovacs D, Scott JT, Jones AP, Harrison EM, Rosala-Hallas A, et al. Evaluation of the effectiveness of remdesivir in severe COVID-19 using observational data from a prospective national cohort study. medRxiv [Internet]. 2022; Available from: https://www.medrxiv.org/content/early/2022/03/09/2021.06.18.21259072
30. Mozaffari E, Chandak A, Zhang Z, Liang S, Thrun M, Gottlieb RL, et al. Remdesivir Treatment in Hospitalized Patients With Coronavirus Disease 2019 (COVID-19): A Comparative Analysis of In-hospital All-cause Mortality in a Large Multicenter Observational Cohort. Clin Infect Dis [Internet]. 2022 Jul 1;75(1):e450–8. Available from: https://doi.org/10.1093/cid/ciab875
31. Stoeckle K, Witting B, Kapadia S, An A, Marks K. Elevated inflammatory markers are associated with poor outcomes in COVID-19 patients treated with remdesivir. J Med Virol [Internet]. 2022 Jan 1;94(1):384–7. Available from: https://doi.org/10.1002/jmv.27280
32. Grundeis F, Ansems K, Dahms K, Thieme V, Metzendorf MI, Skoetz N, et al. Remdesivir for the treatment of COVID-19. Cochrane Database Syst Rev. 2023;2023(1).
33. Antinori S, Cossu MV, Ridolfo AL, Rech R, Bonazzetti C, Pagani G, et al. Compassionate remdesivir treatment of severe Covid-19 pneumonia in intensive care unit (ICU) and Non-ICU patients: Clinical outcome and differences in post-treatment hospitalisation status. Pharmacol Res [Internet]. 2020;158:104899. Available from: https://www.sciencedirect.com/science/article/pii/S104366182031207X
34. Chokkalingam AP, Hayden J, Goldman JD, Li H, Asubonteng J, Mozaffari E, et al. Association of Remdesivir Treatment With Mortality Among Hospitalized Adults With COVID-19 in the United States. JAMA Netw Open [Internet]. 2022 Dec 1;5(12):e2244505–e2244505. Available from: https://doi.org/10.1001/jamanetworkopen.2022.44505
35. Ansems K, Grundeis F, Dahms K, Mikolajewska A, Thieme V, Piechotta V, et al. Remdesivir for the treatment of COVID-19 [Internet]. Vol. 8, The Cochrane database of systematic reviews. Department of Intensive Care Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.; 2021. p. CD014962. Available from: http://europepmc.org/abstract/MED/34350582
36. Amstutz A, Speich B, Mentré F, Rueegg CS, Belhadi D, Assoumou L, et al. Effects of remdesivir in patients hospitalised with COVID-19: a systematic review and individual patient data meta-analysis of randomised controlled trials. Lancet Respir Med. 2023 May 1;11(5):453–64.
37. Solidarity Trial Consortium W. Remdesivir and three other drugs for hospitalised patients with COVID-19: final results of the WHO Solidarity randomised trial and updated meta-analyses. 2022 [cited 2023 Aug 5]; Available from: https://doi.org/10.1016/
38. Finn A, Jindal A, Andrea SB, Selvaraj V, Dapaah-Afriyie K. Association of Treatment with Remdesivir and 30-day Hospital Readmissions in Patients Hospitalized with COVID-19. Am J Med Sci [Internet]. 2022;363(5):403–10. Available from: https://www.sciencedirect.com/science/article/pii/S0002962922000684
39. Hidalgo-Tenorio C, García-Vallecillos C, Sequera-Arquelladas S. Real-world outcomes of COVID-19 treatment with remdesivir in a Spanish hospital. Medicine (Baltimore) [Internet]. 2021;100(37). Available from: https://journals.lww.com/md-journal/Fulltext/2021/09170/Real_world_outcomes_of_COVID_19_treatment_with.38.aspx
40. Tiseo G, Barbieri C, Galfo V, Occhineri S, Matucci T, Almerigogna F, et al. Efficacy and Safety of Nirmatrelvir/Ritonavir, Molnupiravir, and Remdesivir in a Real-World Cohort of Outpatients with COVID-19 at High Risk of Progression: The PISA Outpatient Clinic Experience. Infect Dis Ther [Internet]. 2023;12(1):257–71. Available from: https://doi.org/10.1007/s40121-022-00729-2
41. Ansems K GFDKMATVPVMM-ISMBC, Fichtner F. Remdesivir for the treatment of COVID‐19. Cochrane Database Syst Rev [Internet]. 2021;(8). Available from: https://doi.org//10.1002/14651858.CD014962
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Sep 18, 2023
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Sohail Khan Raja, Hamdah Bashir Mughal, Rubina Rafique Shiekh, Munazza Nazir, Bushra Bashir, Easha tur Razia, Amna Akbar, Sabahat Tasneem, Sarosh Khan Jadoon, & Saddam Hussain. (2023). A COMPREHENSIVE INVESTIGATION INTO THE INFLUENCE OF REMDESIVIR ON MORTALITY AND MORBIDITY AMONG INDIVIDUALS AFFLICTED WITH COVID-19: RETROSPECTIVE COHORT STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 30(17), 1652–1663. https://doi.org/10.53555/jptcp.v30i17.2772
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Author Biographies
Sohail Khan Raja
Assistant Professor, Pulmonologist, AJKMC, Muzaffarabad, AJK, Pakistan
Hamdah Bashir Mughal
MBBS, RMP, AJKMC, Muzaffarabad, AJK, Pakistan
Rubina Rafique Shiekh
Assistant professor Medicine AJKMC, Muzaffarabad, AJK, Pakistan
Munazza Nazir
Associate professor, Medicine, AJKMC, Muzaffarabad, AJK, Pakistan
Bushra Bashir
Demonstrator, Department of Pathology, AJKMC, Muzaffarabad, AJK, Pakistan
Easha tur Razia
Resident Medicine, Abbas Institute of Medical Sciences, Muzaffarabad, AJK, Pakistan
Amna Akbar
Medical Officer, Poonch Medical College Rawalakot, AJK, Pakistan
Sabahat Tasneem
Public Health (MSPH), Health Services Academy, Islamabad, Pakistan
Sarosh Khan Jadoon
Resident surgery, CMH/SKBZ, AJK Muzaffarabad, Pakistan
Saddam Hussain
Senior Medical Officer, Punjab Institute of Neurosciences, Lahore, Pakistan