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在临床环境中,针对德尔塔和奥密克戎SARS-CoV-2变体占主导时期瑞德西韦治疗新冠肺炎有效性的回顾性分析。

Retrospective Analysis of the Effectiveness of Remdesivir in COVID-19 Treatment during Periods Dominated by Delta and Omicron SARS-CoV-2 Variants in Clinical Settings.

作者信息

Dobrowolska Krystyna, Zarębska-Michaluk Dorota, Brzdęk Michał, Rzymski Piotr, Rogalska Magdalena, Moniuszko-Malinowska Anna, Kozielewicz Dorota, Hawro Marcin, Rorat Marta, Sikorska Katarzyna, Jaroszewicz Jerzy, Kowalska Justyna, Flisiak Robert

机构信息

Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland.

Department of Infectious Diseases and Allergology, Jan Kochanowski University, 25-317 Kielce, Poland.

出版信息

J Clin Med. 2023 Mar 19;12(6):2371. doi: 10.3390/jcm12062371.

Abstract

Continuous evaluation of real-world treatment effectiveness of COVID-19 medicines is required due to the ongoing evolution of SARS-CoV-2 and the possible emergence of resistance. Therefore, this study aimed to analyze, in a retrospective manner, the outcomes in patients hospitalized with COVID-19 during the pandemic waves dominated by Delta and Omicron variants and treated with remdesivir (RDV) ( = 762) in comparison to a demographically and clinically matched group not treated with any antivirals ( = 1060). A logistic regression analysis revealed that RDV treatment was associated with a significantly lower risk of death during both Delta wave (OR = 0.42, 95%CI: 0.29-0.60; < 0.0001) and Omicron-dominated period (OR = 0.56, 95%CI: 0.35-0.92; = 0.02). Moreover, RDV-treated groups were characterized by a lower percentage of patients requiring mechanical ventilation, but the difference was not statistically significant. This study is the first real-world evidence that RDV remains effective during the dominance of more pathogenic SARS-CoV-2 variants and those that cause a milder course of the disease, and continues to be an essential element of COVID-19 therapy.

摘要

由于严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的不断演变以及可能出现的耐药性,需要持续评估新冠病毒药物在现实世界中的治疗效果。因此,本研究旨在以回顾性方式分析在由德尔塔和奥密克戎变种主导的疫情期间,因新冠病毒住院并接受瑞德西韦(RDV)治疗(n = 762)的患者的治疗结果,并与未接受任何抗病毒治疗的人口统计学和临床特征匹配的组(n = 1060)进行比较。逻辑回归分析显示,在德尔塔波期间(比值比[OR] = 0.42,95%置信区间[CI]:0.29 - 0.60;P < 0.0001)和奥密克戎主导期(OR = 0.56,95%CI:0.35 - 0.92;P = 0.02),RDV治疗均与显著降低的死亡风险相关。此外,接受RDV治疗的组中需要机械通气的患者百分比更低,但差异无统计学意义。本研究是首个现实世界证据,表明在致病性更强的SARS-CoV-2变种以及导致疾病病程较轻的变种占主导期间,RDV仍然有效,并且仍然是新冠病毒治疗的重要组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7ec/10051185/9c7c39329038/jcm-12-02371-g001.jpg

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