Liu Peng-Huei, Pan Ming-Wei, Huang Yan-Bo, Ng Chip-Jin, Chen Shou-Yen
Department of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
Department of Emergency Medicine, En Chu Kong Hospital, New Taipei City 237, Taiwan.
Life (Basel). 2024 Oct 1;14(10):1252. doi: 10.3390/life14101252.
The COVID-19 pandemic poses severe risks for immunocompromised patients, especially those with neutropenia due to chemotherapy. This study evaluates the safety and effectiveness of remdesivir use in COVID-19 patients with neutropenia.
This retrospective study used the Chang Gung Research Database (CGRD) and extracted data from 98,763 patients with COVID-19 diagnosed between April 2021 and September 2022. The patients were divided into groups based on their remdesivir use and the presence of neutropenia. The adverse effects of remdesivir and their outcomes were analyzed after propensity score matching.
We compared common adverse effects of remdesivir in neutropenic patients before and after a 5-day regimen. A slight decrease in heart rate was observed but lacked clinical significance. There were no significant differences observed in hemoglobin, liver function tests, and blood glucose levels. After propensity score matching of COVID-19 patients with neutropenia according to gender, age, dexamethasone use, oxygen use, MASCC score, and WHO ordinal scale, no significant differences were found in length of stay, intubation rate, or ICU admission rate between the matched patients.
Our study found remdesivir to be safe for COVID-19 patients with neutropenia, with no common adverse reactions observed. However, its effectiveness for these patients remains uncertain.
新冠疫情给免疫功能低下的患者带来了严重风险,尤其是那些因化疗导致中性粒细胞减少的患者。本研究评估了瑞德西韦在新冠中性粒细胞减少患者中的安全性和有效性。
这项回顾性研究使用了长庚研究数据库(CGRD),并提取了2021年4月至2022年9月期间确诊的98763例新冠患者的数据。根据患者是否使用瑞德西韦以及是否存在中性粒细胞减少进行分组。在倾向得分匹配后,分析了瑞德西韦的不良反应及其结果。
我们比较了中性粒细胞减少患者在接受5天疗程前后瑞德西韦的常见不良反应。观察到心率略有下降,但缺乏临床意义。在血红蛋白、肝功能检查和血糖水平方面未观察到显著差异。根据性别、年龄、地塞米松使用情况、吸氧情况、MASCC评分和WHO序贯量表对新冠中性粒细胞减少患者进行倾向得分匹配后,匹配患者之间的住院时间、插管率或ICU入住率均未发现显著差异。
我们的研究发现,瑞德西韦对新冠中性粒细胞减少患者是安全的,未观察到常见不良反应。然而,其对这些患者的有效性仍不确定。