Leding Cæcilie, Bodilsen Jacob, Brieghel Christian, Harboe Zitta Barrella, Helleberg Marie, Holm Claire, Israelsen Simone Bastrup, Jensen Janne, Jensen Tomas Østergaard, Johansen Isik Somuncu, Johnsen Stine, Kirk Ole, Lindegaard Birgitte, Meyer Christian Niels, Mohey Rajesh, Pedersen Lars, Nielsen Henrik, Nielsen Stig Lønberg, Omland Lars Haukali, Podlekareva Daria, Ravn Pernille, Starling Jonathan, Storgaard Merete, Søborg Christian, Søgaard Ole Schmeltz, Tranborg Torben, Wiese Lothar, Worm Signe Heide Westring, Christensen Hanne Rolighed, Benfield Thomas
Center of Research and Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark.
Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
Infect Dis (Lond). 2023 May;55(5):351-360. doi: 10.1080/23744235.2023.2187081. Epub 2023 Mar 11.
The combined effectiveness of remdesivir and dexamethasone in subgroups of hospitalised patients with COVID-19 is poorly investigated.
In this nationwide retrospective cohort study, we included 3826 patients with COVID-19 hospitalised between February 2020 and April 2021. The primary outcomes were use of invasive mechanical ventilation and 30-day mortality, comparing a cohort treated with remdesivir and dexamethasone with a previous cohort treated without remdesivir and dexamethasone. We used inverse probability of treatment weighting logistic regression to assess associations with progression to invasive mechanical ventilation and 30-day mortality between the two cohorts. The analyses were conducted overall and by subgroups based on patient characteristics.
Odds ratio for progression to invasive mechanical ventilation and 30-day mortality in individuals treated with remdesivir and dexamethasone compared to treatment with standard of care alone was 0.46 (95% confidence interval, 0.37-0.57) and 0.47 (95% confidence interval, 0.39-0.56), respectively. The reduced risk of mortality was observed in elderly patients, overweight patients and in patients requiring supplemental oxygen at admission, regardless of sex, comorbidities and symptom duration.
Patients treated with remdesivir and dexamethasone had significantly improved outcomes compared to patients treated with standard of care alone. These effects were observed in most patient subgroups.
瑞德西韦和地塞米松联合使用对住院的2019冠状病毒病（COVID-19）患者亚组的疗效研究较少。
在这项全国性回顾性队列研究中，我们纳入了2020年2月至2021年4月期间住院的3826例COVID-19患者。主要结局是有创机械通气的使用情况和30天死亡率，将接受瑞德西韦和地塞米松治疗的队列与之前未接受瑞德西韦和地塞米松治疗的队列进行比较。我们使用治疗权重逆概率逻辑回归来评估两个队列之间与进展为有创机械通气及30天死亡率的关联。分析在总体上以及根据患者特征按亚组进行。
与仅接受标准治疗相比，接受瑞德西韦和地塞米松治疗的个体进展为有创机械通气和30天死亡率的比值比分别为0.46（95%置信区间，0.37 - 0.57）和0.47（95%置信区间，0.39 - 0.56）。无论性别、合并症和症状持续时间如何，在老年患者、超重患者以及入院时需要补充氧气的患者中均观察到死亡率降低。
与仅接受标准治疗的患者相比，接受瑞德西韦和地塞米松治疗的患者结局有显著改善。这些效果在大多数患者亚组中均有观察到。
