Remdesivir for the treatment of COVID-19 disease: A retrospective comparative study of patients treated with and without Remdesivir

  1. Surabhi Madan
  2. Amit Patel
  3. Kartikae Sharan
  4. Shayon Ghosh
  5. Vishnu Venugopal
  6. Nitesh Shah
  7. Bhagyesh Shah
  8. Vipul Thakkar
  9. Rashmi Chovatiya
  10. Hardik Shah
  11. Pradip Dabhi
  12. Minesh Patel
  13. Bhowmik Meghnathi
  14. Vineet Sankhla
  15. Vipul Kapoor
  16. Tejas Patel
  17. Maulik Soni
  18. Nirav Bapat
  19. Kaivan Shah
  20. Ritanshu Chandarana
  21. Parloop Bhatt
  22. Manish Rana

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Abstract

Background

Remdesivir (RDV) in coronavirus disease 2019 (COVID-19) has been found to be beneficial in patients with severe disease; however, its role in mild-moderate disease and its optimal timing need to be identified.

Objective

To assess the course of illness and final outcome in patients who received RDV at various stages of illness, and compare it to the non-RDV group.

Methods

This is a retrospective data analysis of 1262 COVID-19 patients hospitalized from May5, 2020 to August 31, 2020. The primary outcomes were progression to mechanical ventilation (MV) or death. Kaplan Meier survival analysis and log rank test were used for evaluating primary outcomes.

Results

398 patients comprised the RDV group and 260 patients comprised the non-RDV group. 2/3 rd of patients were above 50 years of age in both the groups and 3/4 th patients were male. Mortality rate was 5.8% in RDV group (10.4% in non-RDV group). Mortality rate was 3.6%, 4% and 16.7% when RDV was started within 5 days, 5 to 10 days and after 10 days of symptom onset respectively. Fewer patients in RDV group progressed to MV (4.0% v/s 8.2%). Earlier discharge occurred in RDV group. Use of supplemental oxygen was observed in 44.7% patients in RDV group (54.2% in non-RDV group). No significant adverse events were observed with RDV. Survival analysis showed that probability of event (death) was significant for patients with hypertension (HT) and/or diabetes mellitus (DM) in RDV group.

Conclusion

Early initiation of RDV is associated with shorter hospital stay, lower mortality as well as reduced need for supplemental oxygen and mechanical ventilation.

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  1. ScreenIT

    SciScore for 10.1101/2021.07.15.21260600: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The study was approved by the CIMS (Care Institute of Medical Sciences) hospital ethics committee (CTRI/2020/05/025247).
    Consent: The need for consent was waived off due to the nature of the study.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data were analyzed using IBM SPSS version 19.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.07.15.21260600v1 on medRxiv