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瑞德西韦在中重度 2019 冠状病毒病(COVID-19)孕妇中的应用:一项回顾性队列研究。

Remdesivir in pregnant women with moderate to severe coronavirus disease 2019 (COVID-19): a retrospective cohort study.

机构信息

Department of Gynecology and Obstetrics, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Pulmonology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Clin Exp Med. 2023 Nov;23(7):3709-3717. doi: 10.1007/s10238-023-01095-0. Epub 2023 Jun 5.

Abstract

Data on the efficacy of remdesivir in Coronavirus Disease 2019 (COVID-19) are limited in pregnant patients since they have been excluded from clinical trials. We aimed to investigate some clinical outcomes following remdesivir administration in pregnancy. This was a retrospective cohort study conducted on pregnant women with moderate to severe COVID-19. The enrolled patients were divided into two groups with and without remdesivir treatment. The primary outcomes of this study were the length of hospital and intensive care unit stay; respiratory parameters of hospital day 7 including respiratory rate, oxygen saturation, and mode of oxygen support; discharge until days 7 and 14, and need for home oxygen therapy. Secondary outcomes included some maternal and neonatal consequences. Eighty-one pregnant women (57 in the remdesivir group and 24 in the non-remdesivir group) were included. The two study groups were comparable according to the baseline demographic and clinical characteristics. Of the respiratory outcomes, remdesivir was significantly associated with a reduced length of hospital stay (p = 0.021) and also with a lower level of oxygen requirement in patients on low-flow oxygen [odds ratio (OR) 3.669]. Among the maternal consequences, no patients in the remdesivir group developed preeclampsia but three patients (12.5%) experienced this complication in the non-remdesivir group (p = 0.024). Furthermore, in patients with moderate COVID-19, the percentage of emergency termination was significantly lower in remdesivir group (OR 2.46). Our results demonstrated some probable benefits of remdesivir in respiratory and also maternal outcomes. Further investigations with a larger sample size should confirm these results.

摘要

关于瑞德西韦在 2019 年冠状病毒病(COVID-19)中疗效的数据在孕妇中是有限的,因为它们被排除在临床试验之外。我们旨在研究妊娠时使用瑞德西韦后一些临床结果。这是一项对患有中重度 COVID-19 的孕妇进行的回顾性队列研究。纳入的患者分为瑞德西韦治疗组和无瑞德西韦治疗组。本研究的主要结局是住院和重症监护病房(ICU)的住院时间;住院第 7 天的呼吸参数,包括呼吸频率、氧饱和度和氧支持方式;出院至第 7 天和第 14 天,以及需要家庭氧疗。次要结局包括一些母婴后果。共纳入 81 名孕妇(瑞德西韦组 57 例,无瑞德西韦组 24 例)。两组患者的基线人口统计学和临床特征相当。在呼吸结局方面,瑞德西韦与住院时间缩短显著相关(p=0.021),也与低流量吸氧患者的氧需求降低有关[比值比(OR)3.669]。在母婴后果方面,瑞德西韦组无患者发生子痫前期,但无瑞德西韦组有 3 例(12.5%)发生该并发症(p=0.024)。此外,在中度 COVID-19 患者中,瑞德西韦组急诊终止妊娠的比例显著降低(OR 2.46)。我们的结果表明瑞德西韦在呼吸和母婴结局方面可能有一些益处。进一步的研究需要更大的样本量来证实这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a72/10241383/889396ac3fa0/10238_2023_1095_Fig1_HTML.jpg

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