Yoshida Manami, Taguchi Nao, Piao Yi, Gupta Rikisha, Peters Jami, Abdelghany Mazin, Chiang Mel, Wang Chen-Yu, Berry Mark, Yotsuyanagi Hiroshi
Gilead Sciences K. K, 1-9-2, Marunouchi, Chiyoda-ku, Tokyo, 100-6616, Japan.
Gilead Sciences K. K, 1-9-2, Marunouchi, Chiyoda-ku, Tokyo, 100-6616, Japan.
J Infect Chemother. 2025 Mar;31(3):102578. doi: 10.1016/j.jiac.2024.12.007. Epub 2024 Dec 6.
Remdesivir (RDV) was approved in Japan for the treatment of coronavirus disease 2019 (COVID-19) in May 2020. However, large-scale research describing the characterized use of RDV in the inpatient setting in Japan is limited. This study aimed to describe the treatment patterns and clinical outcomes of immunocompromised patients with COVID-19 treated with RDV.
We used a secondary nationwide administrative claims database of acute care hospitals in Japan. The study period was from October 19, 2020, to September 30, 2022. Patients with COVID-19 treated with RDV during hospitalization were included, and the proportion of patients with death and disease progression were calculated.
The analysis included a total of 2171 immunocompromised patients treated with RDV. The mean (standard deviation) age at index date was 75.1 (13.6) years. The median time to RDV initiation from hospitalization was 1.0 days (Q1-Q3: 1.0-2.0), and the median duration of RDV treatment was 5.0 days (Q1-Q3: 3.0-5.0). At RDV initiation, 53.02% (n=1151) of patients required non-invasive positive pressure ventilation, nasal high-flow or low-flow oxygen, and 2.26% (n=49) required mechanical ventilation, extracorporeal membrane oxygenation, or intensive care unit admission. Inpatient mortality rate by day 28 was 8.98% (95% confidence interval, 7.81-10.26). By day 28, the rate of disease progression was 9.86% (n=214), and 76.83% (n=1668) were discharged.
This study presents practical information on outcomes and treatment patterns of RDV in immunocompromised inpatients diagnosed with COVID-19.
瑞德西韦（RDV）于2020年5月在日本被批准用于治疗2019冠状病毒病（COVID-19）。然而，关于RDV在日本住院患者中的具体使用情况的大规模研究有限。本研究旨在描述接受RDV治疗的免疫功能低下的COVID-19患者的治疗模式和临床结局。
我们使用了日本急性护理医院的全国性二级行政索赔数据库。研究期间为2020年10月19日至2022年9月30日。纳入住院期间接受RDV治疗的COVID-19患者，并计算死亡和疾病进展患者的比例。
分析共纳入2171例接受RDV治疗的免疫功能低下患者。索引日期的平均（标准差）年龄为75.1（13.6）岁。从住院到开始使用RDV的中位时间为1.0天（第一四分位数-第三四分位数：1.0-2.0），RDV治疗的中位持续时间为5.0天（第一四分位数-第三四分位数：3.0-5.0）。开始使用RDV时，53.02%（n=1151）的患者需要无创正压通气、鼻高流量或低流量吸氧，2.26%（n=49）的患者需要机械通气、体外膜肺氧合或入住重症监护病房。到第28天的住院死亡率为8.98%（95%置信区间，7.81-10.26）。到第28天，疾病进展率为9.86%（n=214），76.83%（n=1668）的患者出院。
本研究提供了关于RDV在诊断为COVID-19的免疫功能低下住院患者中的结局和治疗模式的实用信息。
