Pattern of Remdesivir use and clinical outcome among COVID-19 patients admitted in a tertiary care hospital – A cross sectional case record-based study

Abstract

Context: Remdesivir is the first drug approved by FDA for the treatment of COVID-19 infections. Results of various studies on efficacy and safety of remdesivir all throughout the world were not similar.  

Aims: To assess the pattern of remdesivir use and clinical outcome among the hospitalized patients

Settings and Design: Cross sectional retrospective study conducted at a tertiary care COVID-19 designated hospital, Puducherry.

Methods and Material: Case sheets of adult patients who were on remdesivir and tested positive for COVID-19 were utilised for the study (April-June 2021). Demographic details, duration of hospital stay, Inj. Remdesivir administration details, oxygen support, ICU care and outcome of admission were entered in a pre-structured proforma and analysed using suitable statistical test

Results: Remdesivir was administered to 6% of the patients admitted during the study period. Majority of the patients on remdesivir therapy had moderate COVID pneumonia (47.9%). Most patients were started remdesivir within 1 to 5 days of admission (86.36%). The average days between admission and start of remdesivir was 3.02 days. Majority of the patients received remdesivir for 3 to 5 days (99%). Average duration of remdesivir therapy was 4.08 days. Remdesivir had significantly reduced the symptoms and also shifting of patients to ICU (p value=0.00587). In 214 patients (74.9%) requirement of supplemental oxygen had decreased with subsequent doses of remdesivir treatment and it was statistically significant (p value=0.0075). Remdesivir had significantly reduced the death among COVID pneumonia patients (p value=0.009).

Conclusions: The clinical improvement was 80% with remdesivir treatment. Greater improvement was seen among the younger age group than the older patients. Need of ICU care and mechanical ventilation was less in patients on remdesivir. Early administration has resulted in faster recovery and discharge from the hospital.

Keywords: Remdesivir, COVID-19, Pneumonia, Mechanical ventilation, Co-morbidities