Remdesivir administration for SARS-CoV-2 pneumonia in ICU and non-ICU patients: outcome and posttreatment differences — the Italian Military Hospital experience
Abstract Background Four-hundred forty-nine patients affected by Covid-19 were hospitalized at the Rome Military Hospital between March 2020 and July 2022. Depending on the severity of the disease, they were assigned either to the Functional Health Emergency Unit — if suffering from interstitial pne...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Journal of Anesthesia, Analgesia and Critical Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s44158-023-00114-6 |
| _version_ | 1797555735602659328 |
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| author | Antonio Sabba Giancarlo Pontoni Maria Santangelo Nadir Rachedi Maurizio D’Ercole Bernardino Marseglia Marcella Fusaro Elena Giovanna Bignami Costantino Fontana |
| author_facet | Antonio Sabba Giancarlo Pontoni Maria Santangelo Nadir Rachedi Maurizio D’Ercole Bernardino Marseglia Marcella Fusaro Elena Giovanna Bignami Costantino Fontana |
| author_sort | Antonio Sabba |
| collection | DOAJ |
| description | Abstract Background Four-hundred forty-nine patients affected by Covid-19 were hospitalized at the Rome Military Hospital between March 2020 and July 2022. Depending on the severity of the disease, they were assigned either to the Functional Health Emergency Unit — if suffering from interstitial pneumonia with a clinical manifestation of dyspnea associated with peripheral oxygen saturation < 92%, and oxygen atmospheric pressure therapy — or to the intensive care unit — if the blood gas-lytic index P/F (ratio between partial pressure of arterial O2 and inspired fraction of O2) was below 150. This prospective observation and monocentric study aim to verify the outcome (healing/death) of early use of remdesivir in pneumonia patients. Results The results highlight the importance of the adoption of remdesivir in the initial stages of infection to prevent the systemic spread and viral multiplication and, in the subsequent phase, a cytokine storm resulting in acute respiratory failure and multiorgan failure. The use of the drug in the most advanced stages of the disease is not associated with a real impact on patient outcomes. Therefore, there is a statistically significant correspondence between the early use of remdesivir in the treatment of SARS-CoV-2 disease — in addition to guidelines therapies — and a favorable clinical outcome. Conclusions This work shows therapeutic efficacy in the first 5 days of intravenous administration of remdesivir, following the loading dose. It is also necessary to underline the different behaviors of the drug when administered late in patients undergoing mechanical ventilation, compared to those who only needed low-flow oxygen therapy, whose share of recovery — decidedly relevant — reaches statistical significance. |
| first_indexed | 2024-03-10T16:51:42Z |
| format | Article |
| id | doaj.art-5082b7aa878645d1a7ad30438de3e04a |
| institution | Directory Open Access Journal |
| issn | 2731-3786 |
| language | English |
| last_indexed | 2024-03-10T16:51:42Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Anesthesia, Analgesia and Critical Care |
| spelling | doaj.art-5082b7aa878645d1a7ad30438de3e04a2023-11-20T11:16:36ZengBMCJournal of Anesthesia, Analgesia and Critical Care2731-37862023-09-01311710.1186/s44158-023-00114-6Remdesivir administration for SARS-CoV-2 pneumonia in ICU and non-ICU patients: outcome and posttreatment differences — the Italian Military Hospital experienceAntonio Sabba0Giancarlo Pontoni1Maria Santangelo2Nadir Rachedi3Maurizio D’Ercole4Bernardino Marseglia5Marcella Fusaro6Elena Giovanna Bignami7Costantino Fontana8Rome Military Hospital-Policlinico Militare Di RomaFoligno Army Selection CenterRome Military Hospital-Policlinico Militare Di RomaRome Military Hospital-Policlinico Militare Di RomaRome Military Hospital-Policlinico Militare Di RomaFoligno Army Selection CenterRome Military Hospital-Policlinico Militare Di RomaUniversity of ParmaRome Military Hospital-Policlinico Militare Di RomaAbstract Background Four-hundred forty-nine patients affected by Covid-19 were hospitalized at the Rome Military Hospital between March 2020 and July 2022. Depending on the severity of the disease, they were assigned either to the Functional Health Emergency Unit — if suffering from interstitial pneumonia with a clinical manifestation of dyspnea associated with peripheral oxygen saturation < 92%, and oxygen atmospheric pressure therapy — or to the intensive care unit — if the blood gas-lytic index P/F (ratio between partial pressure of arterial O2 and inspired fraction of O2) was below 150. This prospective observation and monocentric study aim to verify the outcome (healing/death) of early use of remdesivir in pneumonia patients. Results The results highlight the importance of the adoption of remdesivir in the initial stages of infection to prevent the systemic spread and viral multiplication and, in the subsequent phase, a cytokine storm resulting in acute respiratory failure and multiorgan failure. The use of the drug in the most advanced stages of the disease is not associated with a real impact on patient outcomes. Therefore, there is a statistically significant correspondence between the early use of remdesivir in the treatment of SARS-CoV-2 disease — in addition to guidelines therapies — and a favorable clinical outcome. Conclusions This work shows therapeutic efficacy in the first 5 days of intravenous administration of remdesivir, following the loading dose. It is also necessary to underline the different behaviors of the drug when administered late in patients undergoing mechanical ventilation, compared to those who only needed low-flow oxygen therapy, whose share of recovery — decidedly relevant — reaches statistical significance.https://doi.org/10.1186/s44158-023-00114-6Covid-19RemdesivirIntensive care |
| spellingShingle | Antonio Sabba Giancarlo Pontoni Maria Santangelo Nadir Rachedi Maurizio D’Ercole Bernardino Marseglia Marcella Fusaro Elena Giovanna Bignami Costantino Fontana Remdesivir administration for SARS-CoV-2 pneumonia in ICU and non-ICU patients: outcome and posttreatment differences — the Italian Military Hospital experience Journal of Anesthesia, Analgesia and Critical Care Covid-19 Remdesivir Intensive care |
| title | Remdesivir administration for SARS-CoV-2 pneumonia in ICU and non-ICU patients: outcome and posttreatment differences — the Italian Military Hospital experience |
| title_full | Remdesivir administration for SARS-CoV-2 pneumonia in ICU and non-ICU patients: outcome and posttreatment differences — the Italian Military Hospital experience |
| title_fullStr | Remdesivir administration for SARS-CoV-2 pneumonia in ICU and non-ICU patients: outcome and posttreatment differences — the Italian Military Hospital experience |
| title_full_unstemmed | Remdesivir administration for SARS-CoV-2 pneumonia in ICU and non-ICU patients: outcome and posttreatment differences — the Italian Military Hospital experience |
| title_short | Remdesivir administration for SARS-CoV-2 pneumonia in ICU and non-ICU patients: outcome and posttreatment differences — the Italian Military Hospital experience |
| title_sort | remdesivir administration for sars cov 2 pneumonia in icu and non icu patients outcome and posttreatment differences the italian military hospital experience |
| topic | Covid-19 Remdesivir Intensive care |
| url | https://doi.org/10.1186/s44158-023-00114-6 |
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