Impact of Remdesivir on SARS-CoV-2 Clearance in a Real-Life Setting: A Matched-Cohort Study
Vincenzo Spagnuolo,1 Marta Voarino,2 Marco Tonelli,2,3 Laura Galli,1 Andrea Poli,1 Elena Bruzzesi,2 Sara Racca,3 Nicola Clementi,2,3 Chiara Oltolini,1 Moreno Tresoldi,4 Patrizia Rovere Querini,2,5 Lorenzo Dagna,2,6 Alberto Zangrillo,2,7 Fabio Ciceri,2,8 Massimo Clementi,2,3 Antonella Castagna1,2 On...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2022-10-01
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| Series: | Drug Design, Development and Therapy |
| Subjects: | |
| Online Access: | https://www.dovepress.com/impact-of-remdesivir-on-sars-cov-2-clearance-in-a-real-life-setting-a--peer-reviewed-fulltext-article-DDDT |
| _version_ | 1828096428297158656 |
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| author | Spagnuolo V Voarino M Tonelli M Galli L Poli A Bruzzesi E Racca S Clementi N Oltolini C Tresoldi M Rovere Querini P Dagna L Zangrillo A Ciceri F Clementi M Castagna A |
| author_facet | Spagnuolo V Voarino M Tonelli M Galli L Poli A Bruzzesi E Racca S Clementi N Oltolini C Tresoldi M Rovere Querini P Dagna L Zangrillo A Ciceri F Clementi M Castagna A |
| author_sort | Spagnuolo V |
| collection | DOAJ |
| description | Vincenzo Spagnuolo,1 Marta Voarino,2 Marco Tonelli,2,3 Laura Galli,1 Andrea Poli,1 Elena Bruzzesi,2 Sara Racca,3 Nicola Clementi,2,3 Chiara Oltolini,1 Moreno Tresoldi,4 Patrizia Rovere Querini,2,5 Lorenzo Dagna,2,6 Alberto Zangrillo,2,7 Fabio Ciceri,2,8 Massimo Clementi,2,3 Antonella Castagna1,2 On behalf of the COVID-BioB Study Group1Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy; 2Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy; 3Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy; 4General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; 5Internal Medicine, Diabetes, and Endocrinology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; 6Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; 7Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy; 8Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyCorrespondence: Vincenzo Spagnuolo, Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy, Tel +390226437907, Fax +390226437903, Email spagnuolo.vincenzo@hsr.itBackground: Evidence regarding the impact of remdesivir (RDV) on SARS-CoV-2 viral clearance (VC) is scarce. The aim of this study was to compare VC timing in hospitalized COVID-19 patients who did or did not receive RDV.Methods: This was a matched-cohort study of patients hospitalized with pneumonia, a SARS-CoV-2-positive nasopharyngeal swab (NPS) at admission, and at least one NPS during follow-up. Patients who received RDV (cases) and those who did not (controls) were matched in a 1:2 ratio by age, sex, and PaO2/FiO2 (P/F) values at admission. NPSs were analyzed using real-time polymerase chain reaction. Time to VC (within 30 days after hospital discharge) was estimated using the Kaplan–Meier curve. A multivariable Cox proportional hazard model was fitted to determine factors associated with VC.Results: There were 648 patients enrolled in the study (216 cases and 432 controls). VC was observed in 490 patients (75.6%), with a median time of 25 (IQR 16– 34) days. Overall, time to VC was similar between cases and controls (p = 0.519). However, time to VC was different when considering both RDV treatment status and age (p = 0.007). A significant finding was also observed when considering both RDV treatment status and P/F values at admission (p = 0.007). A multivariate analysis showed that VC was associated with a younger age (aHR = 0.990, 95% CI 0.983– 0.998 per every 10-year increase in age; p = 0.009) and a higher baseline P/F ratio (aHR=1.275, 95% CI 1.029– 1.579; p=0.026), but not with RDV treatment status.Conclusion: Time to VC was similar in cases and controls. However, there was a benefit associated with using RDV in regard to time to VC in younger patients and in those with a P/F ratio ≤ 200 mmHg at hospital admission.Keywords: COVID-19, remdesivir, SARS-CoV-2, viral clearance |
| first_indexed | 2024-04-11T07:30:09Z |
| format | Article |
| id | doaj.art-c7952a4fbc874a918f5793f68586468f |
| institution | Directory Open Access Journal |
| issn | 1177-8881 |
| language | English |
| last_indexed | 2024-04-11T07:30:09Z |
| publishDate | 2022-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Drug Design, Development and Therapy |
| spelling | doaj.art-c7952a4fbc874a918f5793f68586468f2022-12-22T04:36:55ZengDove Medical PressDrug Design, Development and Therapy1177-88812022-10-01Volume 163645365479070Impact of Remdesivir on SARS-CoV-2 Clearance in a Real-Life Setting: A Matched-Cohort StudySpagnuolo VVoarino MTonelli MGalli LPoli ABruzzesi ERacca SClementi NOltolini CTresoldi MRovere Querini PDagna LZangrillo ACiceri FClementi MCastagna AVincenzo Spagnuolo,1 Marta Voarino,2 Marco Tonelli,2,3 Laura Galli,1 Andrea Poli,1 Elena Bruzzesi,2 Sara Racca,3 Nicola Clementi,2,3 Chiara Oltolini,1 Moreno Tresoldi,4 Patrizia Rovere Querini,2,5 Lorenzo Dagna,2,6 Alberto Zangrillo,2,7 Fabio Ciceri,2,8 Massimo Clementi,2,3 Antonella Castagna1,2 On behalf of the COVID-BioB Study Group1Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy; 2Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy; 3Unit of Microbiology and Virology, IRCCS San Raffaele Scientific Institute, Milan, Italy; 4General Medicine and Advanced Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; 5Internal Medicine, Diabetes, and Endocrinology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; 6Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy; 7Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy; 8Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalyCorrespondence: Vincenzo Spagnuolo, Unit of Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy, Tel +390226437907, Fax +390226437903, Email spagnuolo.vincenzo@hsr.itBackground: Evidence regarding the impact of remdesivir (RDV) on SARS-CoV-2 viral clearance (VC) is scarce. The aim of this study was to compare VC timing in hospitalized COVID-19 patients who did or did not receive RDV.Methods: This was a matched-cohort study of patients hospitalized with pneumonia, a SARS-CoV-2-positive nasopharyngeal swab (NPS) at admission, and at least one NPS during follow-up. Patients who received RDV (cases) and those who did not (controls) were matched in a 1:2 ratio by age, sex, and PaO2/FiO2 (P/F) values at admission. NPSs were analyzed using real-time polymerase chain reaction. Time to VC (within 30 days after hospital discharge) was estimated using the Kaplan–Meier curve. A multivariable Cox proportional hazard model was fitted to determine factors associated with VC.Results: There were 648 patients enrolled in the study (216 cases and 432 controls). VC was observed in 490 patients (75.6%), with a median time of 25 (IQR 16– 34) days. Overall, time to VC was similar between cases and controls (p = 0.519). However, time to VC was different when considering both RDV treatment status and age (p = 0.007). A significant finding was also observed when considering both RDV treatment status and P/F values at admission (p = 0.007). A multivariate analysis showed that VC was associated with a younger age (aHR = 0.990, 95% CI 0.983– 0.998 per every 10-year increase in age; p = 0.009) and a higher baseline P/F ratio (aHR=1.275, 95% CI 1.029– 1.579; p=0.026), but not with RDV treatment status.Conclusion: Time to VC was similar in cases and controls. However, there was a benefit associated with using RDV in regard to time to VC in younger patients and in those with a P/F ratio ≤ 200 mmHg at hospital admission.Keywords: COVID-19, remdesivir, SARS-CoV-2, viral clearancehttps://www.dovepress.com/impact-of-remdesivir-on-sars-cov-2-clearance-in-a-real-life-setting-a--peer-reviewed-fulltext-article-DDDTcovid-19remdesivirsars-cov-2viral clearance |
| spellingShingle | Spagnuolo V Voarino M Tonelli M Galli L Poli A Bruzzesi E Racca S Clementi N Oltolini C Tresoldi M Rovere Querini P Dagna L Zangrillo A Ciceri F Clementi M Castagna A Impact of Remdesivir on SARS-CoV-2 Clearance in a Real-Life Setting: A Matched-Cohort Study Drug Design, Development and Therapy covid-19 remdesivir sars-cov-2 viral clearance |
| title | Impact of Remdesivir on SARS-CoV-2 Clearance in a Real-Life Setting: A Matched-Cohort Study |
| title_full | Impact of Remdesivir on SARS-CoV-2 Clearance in a Real-Life Setting: A Matched-Cohort Study |
| title_fullStr | Impact of Remdesivir on SARS-CoV-2 Clearance in a Real-Life Setting: A Matched-Cohort Study |
| title_full_unstemmed | Impact of Remdesivir on SARS-CoV-2 Clearance in a Real-Life Setting: A Matched-Cohort Study |
| title_short | Impact of Remdesivir on SARS-CoV-2 Clearance in a Real-Life Setting: A Matched-Cohort Study |
| title_sort | impact of remdesivir on sars cov 2 clearance in a real life setting a matched cohort study |
| topic | covid-19 remdesivir sars-cov-2 viral clearance |
| url | https://www.dovepress.com/impact-of-remdesivir-on-sars-cov-2-clearance-in-a-real-life-setting-a--peer-reviewed-fulltext-article-DDDT |
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