Gilead Sciences, Foster City, CA, 94404, USA.
Certara, Princeton, NJ 08540 , USA.
J Comp Eff Res. 2024 Apr;13(4):e230131. doi: 10.57264/cer-2023-0131. Epub 2024 Feb 29.
This observational study investigated the association between remdesivir treatment during hospitalization for COVID-19 and 30-day COVID-19-related and all-cause readmission across different variants time periods. Hospitalization records for adult patients discharged from a COVID-19 hospitalization between 1 May 2020 to 30 April 2022 were extracted from the US PINC AI Healthcare Database. Likelihood of 30-day readmission was compared among remdesivir-treated and nonremdesivir-treated patients using multivariable logistic regression models adjusted for age, corticosteroid treatment, Charlson comorbidity index and intensive care unit stay during the COVID-19 hospitalization. Analyses were stratified by maximum supplemental oxygen requirement and variant time period (pre-Delta, Delta and Omicron). Of the 440,601 patients discharged alive after a COVID-19 hospitalization, 248,785 (56.5%) patients received remdesivir. Overall, remdesivir patients had a 30-day COVID-19-related readmission rate of 3.0% and all-cause readmission rate of 6.3% compared with 5.4% and 9.1%, respectively, for patients who did not receive remdesivir during their COVID-19 hospitalization. After adjusting for demographics and clinical characteristics, remdesivir treatment was associated with significantly lower odds of 30-day COVID-19-related readmission (odds ratio 0.60 [95% confidence interval: 0.58-0.62]), and all-cause readmission (0.73 [0.72-0.75]). Significantly lower odds of 30-day readmission in remdesivir-treated patients was observed across all variant time periods. Treating patients hospitalized for COVID-19 with remdesivir is associated with a statistically significant reduction in 30-day COVID-19-related and all-cause readmission across variant time periods. These findings indicate that the clinical benefit of remdesivir may extend beyond the COVID-19 hospitalization.
这项观察性研究调查了住院治疗 COVID-19 期间使用瑞德西韦与不同变体时期 30 天 COVID-19 相关和全因再入院之间的关联。从美国 PINC AI 医疗保健数据库中提取了 2020 年 5 月 1 日至 2022 年 4 月 30 日期间出院的成年 COVID-19 住院患者的住院记录。使用多变量逻辑回归模型,根据年龄、皮质类固醇治疗、Charlson 合并症指数和 COVID-19 住院期间的重症监护病房住院情况,比较了瑞德西韦治疗和非瑞德西韦治疗患者的 30 天再入院的可能性。分析按最大补充氧气需求和变体时期(Delta 之前、Delta 和奥密克戎)进行分层。在 COVID-19 住院后存活出院的 440601 名患者中,有 248785 名(56.5%)患者接受了瑞德西韦治疗。总体而言,瑞德西韦患者的 30 天 COVID-19 相关再入院率为 3.0%,全因再入院率为 6.3%,而 COVID-19 住院期间未接受瑞德西韦治疗的患者分别为 5.4%和 9.1%。在调整人口统计学和临床特征后,瑞德西韦治疗与 30 天 COVID-19 相关再入院的几率显著降低相关(比值比 0.60[95%置信区间:0.58-0.62]),全因再入院的几率也显著降低(0.73[0.72-0.75])。在所有变体时期,瑞德西韦治疗患者的 30 天再入院几率均显著降低。对 COVID-19 住院患者使用瑞德西韦治疗与在不同变体时期降低 30 天 COVID-19 相关和全因再入院的几率具有统计学意义。这些发现表明,瑞德西韦的临床获益可能超出 COVID-19 住院治疗的范围。