Prognostic factors for poor outcomes in patients with severe COVID-19 treated with remdesivir plus dexamethasone in Taiwan
Background: Coronavirus disease-2019 (COVID-19) remains a global public health concern, and remdesivir plus dexamethasone combination therapy is suggested for patients with severe disease. However, the factors associated with poor outcomes in these patients remain unclear. We identified the factors...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Journal of Microbiology, Immunology and Infection |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118223001585 |
| _version_ | 1797385253799591936 |
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| author | Yi-Hsuan Lai Yi-Chih Lee I-Ren Chen Shih-Neng Lin Yuh-Lih Chang Chih-Chia Lu Ping-Feng Wu Yi-Tsung Lin |
| author_facet | Yi-Hsuan Lai Yi-Chih Lee I-Ren Chen Shih-Neng Lin Yuh-Lih Chang Chih-Chia Lu Ping-Feng Wu Yi-Tsung Lin |
| author_sort | Yi-Hsuan Lai |
| collection | DOAJ |
| description | Background: Coronavirus disease-2019 (COVID-19) remains a global public health concern, and remdesivir plus dexamethasone combination therapy is suggested for patients with severe disease. However, the factors associated with poor outcomes in these patients remain unclear. We identified the factors associated with poor outcomes in Taiwanese patients with severe COVID-19 treated with remdesivir plus dexamethasone. Methods: Adults with severe COVID-19 (oxygen saturation <94% on room air or requiring supplemental oxygen) treated with remdesivir and dexamethasone were identified between 1 May and 31 July 2021. The main outcomes were 14-day non-recovery, 28-day mortality, and progression to respiratory failure requiring invasive mechanical ventilation or death in initially non-ventilated patients. The prognostic factors associated with poor outcomes were analyzed by multivariate logistic regression and Cox regression. Results: Of the 110 patients treated with remdesivir and dexamethasone, 57 (51.8%) recovered within 14 days and 6 (5.5%) died within 28 days. Of the 89 initially non-ventilated patients, 12 (13.5%) progressed to respiratory failure or death. Charlson Comorbidity Index, SOFA score, and admission to remdesivir treatment interval were associated with 14-day non-recovery. C-reactive protein level was associated with 28-day mortality. Pneumonia Severity Index and admission to remdesivir treatment interval were associated with progression to respiratory failure requiring invasive mechanical ventilation or death in initially non-ventilated patients. Conclusion: High disease severity on admission and delayed initiation of remdesivir therapy were associated with poor outcomes in COVID-19 patients treated with remdesivir and dexamethasone. |
| first_indexed | 2024-03-08T21:51:36Z |
| format | Article |
| id | doaj.art-edb53467678e48a6994894e9d63735a5 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-03-08T21:51:36Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-edb53467678e48a6994894e9d63735a52023-12-20T07:33:54ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822023-12-0156612071213Prognostic factors for poor outcomes in patients with severe COVID-19 treated with remdesivir plus dexamethasone in TaiwanYi-Hsuan Lai0Yi-Chih Lee1I-Ren Chen2Shih-Neng Lin3Yuh-Lih Chang4Chih-Chia Lu5Ping-Feng Wu6Yi-Tsung Lin7Department of Medical Education, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Medical Education, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Pharmacy, National Yang Ming Chiao Tung University, Taipei, TaiwanDepartment of Pharmacy, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDivision of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Corresponding author. Division of Infectious Disease, Department of Medicine, Taipei Veterans General Hospital, Number 201, Section 2, Shih-Pai Road, Beitou District, Taipei 11217, Taiwan. Fax: +886 2 28730052.Background: Coronavirus disease-2019 (COVID-19) remains a global public health concern, and remdesivir plus dexamethasone combination therapy is suggested for patients with severe disease. However, the factors associated with poor outcomes in these patients remain unclear. We identified the factors associated with poor outcomes in Taiwanese patients with severe COVID-19 treated with remdesivir plus dexamethasone. Methods: Adults with severe COVID-19 (oxygen saturation <94% on room air or requiring supplemental oxygen) treated with remdesivir and dexamethasone were identified between 1 May and 31 July 2021. The main outcomes were 14-day non-recovery, 28-day mortality, and progression to respiratory failure requiring invasive mechanical ventilation or death in initially non-ventilated patients. The prognostic factors associated with poor outcomes were analyzed by multivariate logistic regression and Cox regression. Results: Of the 110 patients treated with remdesivir and dexamethasone, 57 (51.8%) recovered within 14 days and 6 (5.5%) died within 28 days. Of the 89 initially non-ventilated patients, 12 (13.5%) progressed to respiratory failure or death. Charlson Comorbidity Index, SOFA score, and admission to remdesivir treatment interval were associated with 14-day non-recovery. C-reactive protein level was associated with 28-day mortality. Pneumonia Severity Index and admission to remdesivir treatment interval were associated with progression to respiratory failure requiring invasive mechanical ventilation or death in initially non-ventilated patients. Conclusion: High disease severity on admission and delayed initiation of remdesivir therapy were associated with poor outcomes in COVID-19 patients treated with remdesivir and dexamethasone.http://www.sciencedirect.com/science/article/pii/S1684118223001585COVID-19RemdesivirDexamethasonePrognostic factorsMortality |
| spellingShingle | Yi-Hsuan Lai Yi-Chih Lee I-Ren Chen Shih-Neng Lin Yuh-Lih Chang Chih-Chia Lu Ping-Feng Wu Yi-Tsung Lin Prognostic factors for poor outcomes in patients with severe COVID-19 treated with remdesivir plus dexamethasone in Taiwan Journal of Microbiology, Immunology and Infection COVID-19 Remdesivir Dexamethasone Prognostic factors Mortality |
| title | Prognostic factors for poor outcomes in patients with severe COVID-19 treated with remdesivir plus dexamethasone in Taiwan |
| title_full | Prognostic factors for poor outcomes in patients with severe COVID-19 treated with remdesivir plus dexamethasone in Taiwan |
| title_fullStr | Prognostic factors for poor outcomes in patients with severe COVID-19 treated with remdesivir plus dexamethasone in Taiwan |
| title_full_unstemmed | Prognostic factors for poor outcomes in patients with severe COVID-19 treated with remdesivir plus dexamethasone in Taiwan |
| title_short | Prognostic factors for poor outcomes in patients with severe COVID-19 treated with remdesivir plus dexamethasone in Taiwan |
| title_sort | prognostic factors for poor outcomes in patients with severe covid 19 treated with remdesivir plus dexamethasone in taiwan |
| topic | COVID-19 Remdesivir Dexamethasone Prognostic factors Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S1684118223001585 |
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