Panda Rajesh, Singh Pooja, Jain Gaurav, Saigal Saurabh, Karna Sunaina T, Anand Abhijeet, Kodamanchili Saiteja, Brahmam Dodda, Jha Surya, Shivhare Aishwary
Department of Anaesthesiology and Critical Care, AIIMS, Bhopal, Madhya Pradesh, India.
Department of Anaesthesiology and Intensive Care, AIIMS, Rishikesh, Uttarakhand, India.
Indian J Crit Care Med. 2022 Sep;26(9):993-999. doi: 10.5005/jp-journals-10071-24189.
Major adverse cardiac events (MACE) are frequent in coronavirus disease-2019 (COVID-19). Remdesivir is used worldwide for treatment in COVID-19. In this retrospective observational study, our primary objective was to assess the impact of remdesivir administration on the incidence of MACE and associated 28 day survival in critically ill patients admitted for moderate to severe COVID-19 pneumonia.
We analyzed the data of 437 patients admitted in intensive care unit (ICU) and divided them into two groups: R group (received remdesivir at ICU admission) and NR group (nonremdesivir) or based on the occurrence of MACE in ICU. We followed the data until discharge, death, or 28 days postadmission. Our primary objective was to investigate the log-odds of survival with remdesivir administration and a correlation/regression analysis of MACE with remdesivir administration in all included patients.
The incidence of MACE was 72 among 437 patients, with 17 (9.3%) patients in R group vs 55 (21.8%) in NR group ( <0.001). On performing correlation analysis between MACE and remdesivir administration, significant correlation coefficient of -0.168 ( = 0.004) was obtained. On regression analysis, the odds ratio for occurrence of MACE with remdesivir administration was 0.362 (regression coefficient: -1.014, <0.001). It indicates a 64% decrease in the log-odds of MACE and a 16% increase in the log-odds of survival with remdesivir administration. All 72 patients with MACE had expired, suggesting a high mortality risk with cardiac complications. The odds ratio for mortality due to MACE with remdesivir administration was 0.216 (regression coefficient: -1.530, -<0.001). It indicates a 79% decrease in the log-odds of death due to MACE with remdesivir administration.
Our study showed significant reduction in MACE and mortality benefit in patients who received remdesivir in comparison to standard treatment.
Panda R, Singh P, Jain G, Saigal S, Karna ST, Anand A, . Effect of Remdesivir Administration on Occurrence of Major Adverse Cardiac Events in Critically Ill COVID-19 Pneumonia: A Retrospective Observational Study. Indian J Crit Care Med 2022;26(9):993-999.
2019冠状病毒病（COVID-19）患者中，主要不良心脏事件（MACE）很常见。瑞德西韦在全球范围内用于COVID-19的治疗。在这项回顾性观察研究中，我们的主要目的是评估在因中度至重度COVID-19肺炎入院的重症患者中，使用瑞德西韦对MACE发生率及28天生存率的影响。
我们分析了437名入住重症监护病房（ICU）患者的数据，并将他们分为两组：瑞德西韦组（在ICU入院时接受瑞德西韦治疗）和非瑞德西韦组（未接受瑞德西韦治疗），或根据ICU中MACE的发生情况分组。我们跟踪数据直至出院、死亡或入院后28天。我们的主要目的是研究在所有纳入患者中，使用瑞德西韦治疗的生存对数几率，以及MACE与使用瑞德西韦治疗之间的相关性/回归分析。
437名患者中，MACE的发生率为72例，瑞德西韦组有17例（9.3%），而非瑞德西韦组有55例（21.8%）（P<0.001）。在对MACE与使用瑞德西韦治疗进行相关性分析时，得到显著的相关系数为-0.168（P = 0.004）。在回归分析中，使用瑞德西韦治疗发生MACE的比值比为0.362（回归系数：-1.014，P<0.001）。这表明使用瑞德西韦治疗使MACE的对数几率降低了64%，生存对数几率提高了16%。所有72例发生MACE的患者均已死亡，提示心脏并发症的死亡风险很高。使用瑞德西韦治疗因MACE导致的死亡比值比为0.216（回归系数：-1.530，P<0.001）。这表明使用瑞德西韦治疗使因MACE导致的死亡对数几率降低了79%。
我们的研究表明，与标准治疗相比，接受瑞德西韦治疗的患者MACE显著减少，且有生存获益。
Panda R, Singh P, Jain G, Saigal S, Karna ST, Anand A, 等。瑞德西韦治疗对重症COVID-19肺炎患者主要不良心脏事件发生的影响：一项回顾性观察研究。《印度重症监护医学杂志》2022；26(9):993 - 999。
