Ramos-Rincon Jose-Manuel, López-Carmona María-Dolores, Cobos-Palacios Lidia, López-Sampalo Almudena, Rubio-Rivas Manuel, Martín-Escalante María-Dolores, de-Cossio-Tejido Santiago, Taboada-Martínez María-Luisa, Muiño-Miguez Antonio, Areses-Manrique Maria, Martinez-Cilleros Carmen, Tuñón-de-Almeida Carlota, Abella-Vázquez Lucy, Martínez-Gonzalez Angel-Luís, Díez-García Luis-Felipe, Ripper Carlos-Jorge, Asensi Victor, Martinez-Pascual Angeles, Guisado-Vasco Pablo, Lumbreras-Bermejo Carlos, Gómez-Huelgas Ricardo
Department of Clinical Medicine, Miguel Hernandez University of Elche, Ctra N332 s/n, 03550 Alicante, Spain.
Department of Internal Medicine, Instituto de Investigacion Biomedica de Málaga (IBIMA), Regional University Hospital of Málaga, 29010 Málaga, Spain.
J Clin Med. 2022 Jun 29;11(13):3769. doi: 10.3390/jcm11133769.
(1) Background: Large cohort studies of patients with COVID-19 treated with remdesivir have reported improved clinical outcomes, but data on older patients are scarce. Objective: This work aims to assess the potential benefit of remdesivir in unvaccinated very old patients hospitalized with COVID-19; (2) Methods: This is a retrospective analysis of patients ≥ 80 years hospitalized in Spain between 15 July and 31 December 2020 (SEMI-COVID-19 Registry). Differences in 30-day all-cause mortality were adjusted using a multivariable regression analysis. (3) Results: Of the 4331 patients admitted, 1312 (30.3%) were ≥80 years. Very old patients treated with remdesivir (n: 140, 10.7%) had a lower mortality rate than those not treated with remdesivir (OR (95% CI): 0.45 (0.29−0.69)). After multivariable adjustment by age, sex, and variables associated with lower mortality (place of COVID-19 acquisition; degree of dependence; comorbidities; dementia; duration of symptoms; admission qSOFA; chest X-ray; D-dimer; and treatment with corticosteroids, tocilizumab, beta-lactams, macrolides, and high-flow nasal canula oxygen), the use of remdesivir remained associated with a lower 30-day all-cause mortality rate (adjusted OR (95% CI): 0.40 (0.22−0.61) (p < 0.001)). (4) Conclusions: Remdesivir may reduce mortality in very old patients hospitalized with COVID-19.
（1）背景：关于接受瑞德西韦治疗的新冠患者的大型队列研究报告了临床结局的改善，但老年患者的数据稀缺。目的：本研究旨在评估瑞德西韦对因新冠住院的未接种疫苗的高龄患者的潜在益处；（2）方法：这是一项对2020年7月15日至12月31日期间在西班牙住院的≥80岁患者的回顾性分析（SEMI-COVID-19注册研究）。使用多变量回归分析调整30天全因死亡率的差异。（3）结果：在4331名入院患者中，1312名（30.3%）≥80岁。接受瑞德西韦治疗的高龄患者（n：140，10.7%）的死亡率低于未接受瑞德西韦治疗的患者（OR（95%CI）：0.45（0.29−0.69））。在按年龄、性别以及与较低死亡率相关的变量（新冠感染地点；依赖程度；合并症；痴呆；症状持续时间；入院时qSOFA；胸部X光；D-二聚体；以及使用皮质类固醇、托珠单抗、β-内酰胺类、大环内酯类和高流量鼻导管吸氧治疗）进行多变量调整后，使用瑞德西韦仍与较低的30天全因死亡率相关（调整后OR（95%CI）：0.40（0.22−0.61）（p<0.001））。（4）结论：瑞德西韦可能降低因新冠住院的高龄患者的死亡率。
