Department of Internal Medicine, School of Medicine, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran.
Department of Infectious Diseases, School of Medicine, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran.
PLoS One. 2022 Nov 10;17(11):e0277413. doi: 10.1371/journal.pone.0277413. eCollection 2022.
Since the late COVID-19, many countries have faced various surges and peaks within the number of infected. Iran was one of the countries that faced many surges and peaks within these years and faced many inadequacies and shortages of resources and hospital beds. Hence the healthcare system started using in-hospital medication such as Remdesivir in outpatients to reduce the load of patients admitted to the hospital. This study aimed to evaluate and compare the reported signs, symptoms, and outcomes of COVID-infected hospitalized and out-patients receiving Remdesivir.
In this retrospective cohort study, 214 patients (121 outpatient and 93 hospitalized) with moderate levels of Covid infection between October 2021 and February 2022 were studied. Both groups were treated with 200mg of Remdesivir, followed by 100 mg daily intravenous injections for five days; signs and symptoms, such as pain, shortness of breath, cough, fever and etc., of patients at the initiation and the end of treatment were recorded. Moreover, the patients' blood oxygen saturation was assessed two to three times a day, and the mean of the recorded measures was considered as the daily oxygen saturation. The outpatient group had to visit the hospital daily for treatment and assessment. At the treatment's end, mortality rates, disease signs, and symptoms alleviations were compared between the groups.
The outpatient and hospitalized group's mean age was 40.30 ± 12.25 and 37.70 ± 12.00 years, and 51.2% and 55.9% were males, respectively. There was no statistical difference between baseline and clinical characteristics in the outpatients and hospitalized groups. After adjusting for oxygen saturation at baseline and gender in the multivariable Cox regression analysis, the risk of death did not statistically differ between the hospitalized and outpatient group (hazard ratio: 0.99, 95% confidence interval: 0.39-2.50)) at the end of the study.
Based on the results of this study, the outcome, signs, and symptoms of inpatient and outpatient Remdesivir treatment groups did not differ significantly. Hence in COVID-19 surges where we have limitations in admitting patients, outpatient Remdesivir treatment for those without any underlying diseases can be a proper management method.
自新冠疫情后期以来，许多国家的感染人数都经历了多次激增和高峰。伊朗是这些年面临多次激增和高峰的国家之一，其面临着资源和医院床位的诸多不足和短缺。因此，医疗系统开始在门诊中使用住院药物，如瑞德西韦，以减少住院患者的负担。本研究旨在评估和比较接受瑞德西韦治疗的住院和门诊 COVID 感染患者的报告症状、体征和结局。
在这项回顾性队列研究中，研究了 2021 年 10 月至 2022 年 2 月期间患有中度新冠感染的 214 名患者（121 名门诊患者和 93 名住院患者）。两组患者均接受 200mg 瑞德西韦治疗，随后静脉注射 100mg 每日一次，连续 5 天；记录患者治疗开始和结束时的疼痛、呼吸急促、咳嗽、发热等体征和症状。此外，每天评估两次或三次患者的血氧饱和度，将记录的测量值的平均值作为每日血氧饱和度。门诊组每天必须到医院接受治疗和评估。在治疗结束时，比较两组之间的死亡率、疾病体征和症状缓解情况。
门诊组和住院组的平均年龄分别为 40.30±12.25 岁和 37.70±12.00 岁，分别有 51.2%和 55.9%的患者为男性。门诊组和住院组在基线和临床特征方面没有统计学差异。在校正基线时的血氧饱和度和性别后，多变量 Cox 回归分析显示，住院组和门诊组在研究结束时的死亡风险无统计学差异（危险比：0.99，95%置信区间：0.39-2.50）。
根据本研究结果，住院和门诊瑞德西韦治疗组的结局、体征和症状无显著差异。因此，在我们在收治患者方面存在限制的新冠疫情高峰期，对于没有任何基础疾病的患者，门诊瑞德西韦治疗可能是一种适当的管理方法。
