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瑞德西韦在 COVID-19 肺炎住院患者中的应用:对低氧和炎症状态的影响。

Use of Remdesivir in Patients Hospitalized for COVID-19 Pneumonia: Effect on the Hypoxic and Inflammatory State.

机构信息

Regional Referral Centre for Rare Lung Disease, University Hospital "Policlinico-San Marco", Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.

Department of Biomedical and Biotechnological Sciences, Unit of Infectious Diseases, University of Catania, 95123 Catania, Italy.

出版信息

Viruses. 2023 Oct 17;15(10):2101. doi: 10.3390/v15102101.

Abstract

Remdesivir is one of the most attractive options for patients with hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19). The aim of our study was to evaluate the effect of remdesivir on the hypoxic and inflammatory state in patients with moderate to severe COVID-19. We retrospectively enrolled 112 patients admitted for COVID-19 pneumonia, requiring low-flow oxygen, 57 treated with remdesivir plus standard of care (SoC) and 55 treated only with SoC that were similar for demographic and clinical data. We evaluated changes in hypoxemia and inflammatory markers at admission (Day 0) and after 5 days of treatment (Day 5) and the clinical course of the disease. From Day 0 to Day 5, the ratio of arterial oxygen partial pressure to fractional inspired oxygen (P/F) increased from 222 ± 62 to 274 ± 97 ( < 0.0001) in the remdesivir group and decreased from 223 ± 62 to 183 ± 76 ( < 0.05) in the SoC group. Interleukine-6 levels decreased in the remdesivir (45.9 to 17.5 pg/mL, < 0.05) but not in the SoC group. Remdesivir reduced the need for ventilatory support and the length of hospitalization. In conclusion, compared to standard care, remdesivir rapidly improves hypoxia and inflammation, causing a better course of the disease in moderate to severe COVID-19.

摘要

瑞德西韦是治疗因 2019 年冠状病毒病(COVID-19)导致低氧性呼吸衰竭患者的最有吸引力的选择之一。我们的研究目的是评估瑞德西韦对中重度 COVID-19 患者缺氧和炎症状态的影响。我们回顾性纳入了 112 例因 COVID-19 肺炎入院、需要低流量吸氧的患者,其中 57 例接受瑞德西韦联合标准治疗(SoC)治疗,55 例仅接受 SoC 治疗,两组在人口统计学和临床数据方面相似。我们评估了入院时(第 0 天)和治疗 5 天后(第 5 天)的低氧血症和炎症标志物的变化以及疾病的临床过程。从第 0 天到第 5 天,瑞德西韦组的动脉血氧分压与吸入氧分数比值(P/F)从 222±62 增加到 274±97(<0.0001),而 SoC 组从 223±62 减少到 183±76(<0.05)。瑞德西韦组的白细胞介素-6 水平下降(45.9 至 17.5 pg/mL,<0.05),而 SoC 组则无变化。瑞德西韦组降低了通气支持的需求和住院时间。总之,与标准治疗相比,瑞德西韦可迅速改善缺氧和炎症,使中重度 COVID-19 的疾病过程得到改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a064/10612076/db12b95871c4/viruses-15-02101-g001.jpg

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