Real-world use of remdesivir for the treatment of patients admitted to Italian hospitals with COVID-19: the nationwide retrospective FADOI-RECOVER study

BMC Infect Dis. 2023 Jul 8;23(1):454. doi: 10.1186/s12879-023-08422-6.

Abstract

Background: Remdesivir is widely used for treatment of SARS-CoV-2 pneumonia. The aim of this study was to evaluate the characteristics of patients with moderate-to-severe COVID-19 treated with remdesivir, and their outcomes during hospitalization.

Methods: This retrospective observational multicenter study included consecutive patients, hospitalized for moderate-to-severe COVID-19 (September 2020-September 2021), who were treated with remdesivir.

Results: One thousand four patients were enrolled, all with onset of symptoms occurring less than 10 days before starting remdesivir; 17% of patients had 4 or more concomitant diseases. Remdesivir was well tolerated, adverse drug reactions (ADRs) being reported in 2.3% of patients. In-hospital death occurred in 80 patients (8.0%). The median timing of the first remdesivir dose was 5 days after symptom onset. The following endpoints did not differ according to the time span from the onset of symptoms to the first dose: length of hospitalization, in-hospital death, composite outcome (in-hospital death and/or endotracheal intubation). Advanced age, number of comorbidities ≥ 4, and severity of respiratory failure at admission were associated with poor in-hospital outcomes.

Conclusion: In a real-world setting, remdesivir proved to be a safe and well-tolerated treatment for moderate-to-severe COVID-19. In patients receiving remdesivir less than 3 or 5 days from the onset of SARS-CoV-2 symptoms, mortality and the need for mechanical ventilation did not differ from the rest of the sample.

Keywords: COVID-19 pneumonia; Internal Medicine; Management of COVID-19; Remdesivir.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Antiviral Agents / adverse effects
  • COVID-19 Drug Treatment
  • COVID-19*
  • Hospital Mortality
  • Hospitalization
  • Hospitals
  • Humans
  • Retrospective Studies
  • SARS-CoV-2

Substances

  • remdesivir
  • Antiviral Agents