Medisys Hospitals, LB nagar, Hyderabad, Telangana, India.
Chilkur Balaji College of Pharmacy, Hyderabad, Telangana, India.
J Infect Dev Ctries. 2023 Jul 27;17(7):953-960. doi: 10.3855/jidc.17971.
The aim of this study was to demonstrate the purpose of adding antiviral (remdesivir) to the existing steroidal (dexamethasone) therapy in treating coronavirus disease 2019 (COVID-19).
A retrospective observational case cohort study was carried out to compare the effect of dexamethasone alone and in combination with remdesivir in treating moderate and severe COVID-19 disease. The patients were divided into 2 groups: Group 1 included patients treated with dexamethasone alone, and Group 2 included patients treated with dexamethasone and remdesivir. Levels of inflammatory markers (C-reactive protein, D- dimer and lactate dehydrogenase), World Health Organization (WHO) ordinal scale scoring, symptomatic improvement in terms of fever, cough, shortness of breath, 6-minutes' walk test and SpO2 levels on day of admission (D0), 3 days and 5 days after admission (D3 and D5), and 10 days overall outcome (determined as death, or discharge with or without Long Term Oxygenation Therapy) were collected and analyzed.
Addition of remdesivir to dexamethasone in treating COVID 19 did not have any additional benefits. No additional role of remdesivir is seen in combating the disease except in case of 10 days outcome. However, the better 10-day outcome associated with the use of remdesivir was thought to be due to the patients who were on mechanical ventilation in the dexamethasone treated group at the time of inclusion.
Since a similar trend was seen in both groups, our study concluded no additional role of remdesivir in combating COVID-19.
本研究旨在展示在现有类固醇(地塞米松)治疗方案中添加抗病毒药物(瑞德西韦)治疗 2019 年冠状病毒病(COVID-19)的目的。
本研究采用回顾性观察性病例队列研究,比较了单独使用地塞米松和联合使用瑞德西韦治疗中重度 COVID-19 的效果。患者分为两组:第 1 组为单独使用地塞米松治疗的患者,第 2 组为使用地塞米松和瑞德西韦联合治疗的患者。收集并分析炎症标志物(C 反应蛋白、D-二聚体和乳酸脱氢酶)、世界卫生组织(WHO)等级评分、发热、咳嗽、呼吸急促、6 分钟步行试验和入院当天(D0)、第 3 天(D3)和第 5 天(D5)的 SpO2 水平、以及 10 天的总体结局(死亡或出院,包括是否需要长期氧疗)等方面的症状改善情况。
瑞德西韦联合地塞米松治疗 COVID-19 并没有带来额外的益处。除了 10 天的结局外,瑞德西韦在治疗疾病方面没有发挥额外的作用。然而,瑞德西韦治疗组的患者在纳入时已经需要机械通气,这可能是使用瑞德西韦后 10 天结局更好的原因。
由于两组均呈现出相似的趋势,因此我们的研究结论是瑞德西韦在治疗 COVID-19 方面没有额外的作用。