Marko Lucijanić, Hematology Department, University Hospital Dubrava, Av. Gojka Šuška 6, 10000 Zagreb, Croatia,
Croat Med J. 2022 Dec 31;63(6):536-543. doi: 10.3325/cmj.2022.63.536.
To evaluate the association of remdesivir use and the survival of hospitalized patients with coronavirus disease 2019 (COVID-19).
We retrospectively reviewed the medical records of 5959 COVID-19 patients admitted to our tertiary-level hospital from March 2020 to June 2021. A total of 876 remdesivir-treated patients were matched with 876 control patients in terms of age, sex, Charlson comorbidity index (CCI), WHO-defined COVID-19 severity on admission, and oxygen requirement at the time of remdesivir use.
Among 1752 COVID-19 patients (median age 66 years, 61.8% men), 1405 (80.2%) had severe and 311 (17.8%) had critically severe COVID-19 on admission. Remdesivir was given at a median of one day after hospital admission and at a median of eight days from the onset of symptoms. Overall, 645 (73.6%) patients received remdesivir before high-flow oxygen therapy (HFOT) or mechanical ventilation (MV), 198 (22.6%) after HFOT institution, and 83 (9.5%) after MV institution. Remdesivir use was associated with improved survival in the entire cohort (hazard ratio 0.79, P=0.006). Survival benefit was evident among patients receiving remdesivir during low-flow oxygen requirement (hazard ratio 0.61, P<0.001) but not among patients who received it after starting HFOT (P=0.499) or MV (P=0.380).
Remdesivir, if given during low-flow oxygen therapy, might be associated with survival benefit in hospitalized COVID-19 patients.
评估瑞德西韦的使用与住院的 2019 冠状病毒病（COVID-19）患者的生存情况之间的关联。
我们回顾性地分析了 2020 年 3 月至 2021 年 6 月期间在我院接受治疗的 5959 例 COVID-19 患者的病历。根据年龄、性别、Charlson 合并症指数（CCI）、入院时世界卫生组织（WHO）定义的 COVID-19 严重程度以及使用瑞德西韦时的氧气需求，将 876 例接受瑞德西韦治疗的患者与 876 例对照患者进行了匹配。
在 1752 例 COVID-19 患者中（中位年龄为 66 岁，61.8%为男性），1405 例（80.2%）患者入院时患有重症 COVID-19，311 例（17.8%）患者患有危重症 COVID-19。瑞德西韦的中位使用时间为入院后 1 天，中位使用时间为症状出现后 8 天。总体而言，645 例（73.6%）患者在接受高流量氧气治疗（HFOT）或机械通气（MV）之前接受了瑞德西韦治疗，198 例（22.6%）在 HFOT 开始后接受了治疗，83 例（9.5%）在 MV 开始后接受了治疗。瑞德西韦的使用与整个队列的生存改善相关（风险比 0.79，P=0.006）。在接受低流量氧气需求治疗的患者中，瑞德西韦的使用与生存获益相关（风险比 0.61，P<0.001），而在接受 HFOT 或 MV 治疗的患者中，瑞德西韦的使用与生存获益无关（P=0.499，P=0.380）。
如果在低流量氧气治疗期间使用瑞德西韦，可能与住院 COVID-19 患者的生存获益相关。
