Kintrilis Nikolaos, Galinos Iosif
Infectious Diseases Unit, 401 General Military Hospital of Athens, Athens, Greece.
Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Recent Adv Antiinfect Drug Discov. 2024;19(2):173-178. doi: 10.2174/2772434418666230331083714.
Remdesivir, a viral RNA polymerase inhibitor, has been a powerful weapon in the battle against the SARS-CoV-2 pandemic. Originally approved for use in hospitalized patients, remdesivir improves clinical outcomes in patients with moderate to severe coronavirus disease 2019 (COVID-19). After proving efficacious in hospitalized patients, its use was approved in early disease for symptomatic, non-hospitalized patients that present risk factors for progression to severe disease.
To evaluate whether administration of the antiviral medication remdesivir at an outpatient basis has an effect on hospital admissions of patients presenting with SARSCoV- 2 infection.
We conducted an observational clinical trial involving 107 non-hospitalized COVID-19 patients who attended the emergency department of a third-level greek hospital seeking care for symptoms appearing within the previous 5 days and who had at least one risk factor for progression to severe disease. After arterial blood gas evaluation, eligible patients received intravenous remdesivir at a dose of 200 mg on day 1 and 100 mg on days 2 and 3. The efficacy endpoint was set as COVID-19-related hospitalization or death in the next 14 days.
A total of 107 patients (57.0% men) participated in the study, 51 (47.7%) of them fully vaccinated. Most prevalent were age ≥ 60 years old, cardiovascular/cerebrovascular disease, immunosuppression or malignancy, obesity, diabetes mellitus, and chronic lung disease. All patients enrolled completed the 3-day course, with a total of 3 out of 107 patients (2.8%) eventually having a COVID-19-related hospitalization by day 14, while no deaths were reported by day 14.
Among non-hospitalized patients with at least one risk factor for progression to severe COVID-19, a 3-day course of intravenous remdesivir yielded favourable results.
瑞德西韦是一种病毒RNA聚合酶抑制剂，在抗击新型冠状病毒肺炎大流行的战斗中一直是有力武器。瑞德西韦最初被批准用于住院患者，可改善中度至重度2019冠状病毒病（COVID-19）患者的临床结局。在证明对住院患者有效后，其使用被批准用于有进展为重症疾病风险因素的有症状非住院患者的早期疾病治疗。
评估在门诊给予抗病毒药物瑞德西韦对出现新型冠状病毒2感染患者住院情况的影响。
我们进行了一项观察性临床试验，纳入了107名非住院的COVID-19患者，这些患者前往希腊一家三级医院的急诊科就诊，他们在过去5天内出现症状，且至少有一个进展为重症疾病的风险因素。在进行动脉血气评估后，符合条件的患者在第1天接受200毫克静脉注射瑞德西韦，在第2天和第3天接受100毫克。疗效终点设定为未来14天内与COVID-19相关的住院或死亡。
共有107名患者（57.0%为男性）参与研究，其中51名（47.7%）完全接种了疫苗。最常见的是年龄≥60岁、心血管/脑血管疾病、免疫抑制或恶性肿瘤、肥胖、糖尿病和慢性肺病。所有纳入的患者均完成了3天疗程，107名患者中有3名（2.8%）最终在第14天因COVID-19相关原因住院，而到第14天未报告死亡病例。
在有至少一个进展为重症COVID-19风险因素的非住院患者中，为期3天的静脉注射瑞德西韦疗程产生了良好结果。
