瑞德西韦在住院 COVID-19 患者中的安全性和临床结局:主动监测数据库的回顾性分析。
Safety and clinical outcomes of remdesivir in hospitalised COVID-19 patients: a retrospective analysis of active surveillance database.
机构信息
Medical Services, Cipla Ltd., Mumbai, India.
Head Clinical Research, Cipla Ltd., Mumbai, India.
出版信息
BMC Infect Dis. 2022 Jan 4;22(1):1. doi: 10.1186/s12879-021-07004-8.
BACKGROUND
Real-world data on safety and clinical outcomes of remdesivir in COVID-19 management is scant. We present findings of data analysis conducted for assessing the safety and clinical outcomes of remdesivir treatment for COVID-19 in India.
METHODS
This retrospective analysis used data from an active surveillance programme database of hospitalised patients with COVID-19 who were receiving remdesivir.
RESULTS
Of the 2329 patients included, 67.40% were men. Diabetes (29.69%) and hypertension (20.33%) were the most common comorbidities. At remdesivir initiation, 2272 (97.55%) patients were receiving oxygen therapy. Remdesivir was administered for 5 days in 65.38% of patients. Antibiotics (64.90%) and steroids (47.90%) were the most common concomitant medications. Remdesivir was overall well tolerated, and total 119 adverse events were reported; most common were nausea and vomiting in 45.40% and increased liver enzymes in 14.28% patients. 84% of patients were cured/improved, 6.77% died and 9.16% showed no improvement in their clinical status at data collection. Subgroup analyses showed that the mortality rate was significantly lower in patients < 60 years old than in those > 60 years old. Amongst patients on oxygen therapy, the cure/improvement rate was significantly higher in those receiving standard low-flow oxygen than in those receiving mechanical ventilation, non-invasive ventilation, or high-flow oxygen. Factors that were associated with higher mortality were age > 60 years, cardiac disease, diabetes high flow oxygen, non-invasive ventilation and mechanical ventilation.
CONCLUSION
Our analysis showed that remdesivir is well tolerated and has an acceptable safety profile. The clinical outcome of cure/improvement was 84%, with a higher improvement in patients < 60 years old and on standard low-flow oxygen.
背景
关于瑞德西韦在 COVID-19 管理中的安全性和临床结果的真实世界数据很少。我们报告了为评估瑞德西韦治疗 COVID-19 在印度的安全性和临床结果而进行的数据分析结果。
方法
这项回顾性分析使用了来自住院 COVID-19 患者瑞德西韦治疗的主动监测计划数据库中的数据。
结果
在 2329 名患者中,67.40%为男性。糖尿病(29.69%)和高血压(20.33%)是最常见的合并症。在开始使用瑞德西韦时,2272 名(97.55%)患者正在接受氧气治疗。65.38%的患者使用瑞德西韦 5 天。抗生素(64.90%)和皮质类固醇(47.90%)是最常见的伴随药物。瑞德西韦总体耐受性良好,共报告了 119 例不良事件;最常见的是恶心和呕吐(45.40%)和肝酶升高(14.28%)。84%的患者治愈/好转,6.77%死亡,9.16%在数据收集时临床状况无改善。亚组分析显示,<60 岁患者的死亡率明显低于>60 岁患者。在接受氧气治疗的患者中,接受标准低流量氧气治疗的患者治愈率/好转率明显高于接受机械通气、无创通气或高流量氧气治疗的患者。与死亡率较高相关的因素是年龄>60 岁、心脏病、糖尿病、高流量氧气、无创通气和机械通气。
结论
我们的分析表明,瑞德西韦具有良好的耐受性和可接受的安全性。治愈率/好转率为 84%,<60 岁患者和接受标准低流量氧气治疗的患者改善率更高。