Remdesivir for the treatment of patients hospitalized with COVID-19 receiving supplemental oxygen: a targeted literature review and meta-analysis
Por:
Beckerman, R, Gori, A, Jeyakumar, S, Malin, JJ, Paredes, R, Povoa, P, Smith, NJ and Teixeira-Pinto, A
Publicada:
10 jun 2022
Resumen:
This network meta-analysis (NMA) assessed the efficacy of remdesivir in hospitalized patients with COVID-19 requiring supplemental oxygen. Randomized controlled trials of hospitalized patients with COVID-19, where patients were receiving supplemental oxygen at baseline and at least one arm received treatment with remdesivir, were identified. Outcomes included mortality, recovery, and no longer requiring supplemental oxygen. NMAs were performed for low-flow oxygen (LFO2); high-flow oxygen (HFO2), including NIV (non-invasive ventilation); or oxygen at any flow (AnyO(2)) at early (day 14/15) and late (day 28/29) time points. Six studies were included (N = 5245 patients) in the NMA. Remdesivir lowered early and late mortality among AnyO(2) patients (risk ratio (RR) 0.52, 95% credible interval (CrI) 0.34-0.79; RR 0.81, 95%CrI 0.69-0.95) and LFO2 patients (RR 0.21, 95%CrI 0.09-0.46; RR 0.24, 95%CrI 0.11-0.48); no improvement was observed among HFO2 patients. Improved early and late recovery was observed among LFO2 patients (RR 1.22, 95%CrI 1.09-1.38; RR 1.17, 95%CrI 1.09-1.28). Remdesivir also lowered the requirement for oxygen support among all patient subgroups. Among hospitalized patients with COVID-19 requiring supplemental oxygen at baseline, use of remdesivir compared to best supportive care is likely to improve the risk of mortality, recovery and need for oxygen support in AnyO(2) and LFO2 patients.
Filiaciones:
Beckerman, R:
Maple Hlth Grp, New York, NY USA
Gori, A:
Univ Milan, Infect Dis Unit, Ctr Multidisciplinary Res Hlth Sci MACH, Fdn IRCCS Ca Granda Osped Maggiore Policlin, Milan, Italy
Jeyakumar, S:
Maple Hlth Grp, New York, NY USA
Malin, JJ:
Univ Cologne, Univ Hosp Cologne, Div Infect Dis, Dept Internal Med 1,Fac Med, Cologne, Germany
:
Hosp Badalona Germans Trias & Pujol, Infect Dis Dept, Badalona, Spain
Hosp Badalona Germans Trias & Pujol, IrsiCaixa AIDS Res Inst, Badalona, Spain
Case Western Reserve Univ, Sch Med, Dept Pathol, Ctr Global Hlth & Dis, Cleveland, OH 44106 USA
Univ Nova Lisboa, Nova Med Sch, CHRC, Lisbon, Portugal
Povoa, P:
OUH Odense Univ Hosp, Ctr Clin Epidemiol, Odense, Denmark
OUH Odense Univ Hosp, Res Unit Clin Epidemiol, Odense, Denmark
CHLO, Hosp Sao Francisco Xavier, Polyvalent Intens Care Unit, Lisbon, Portugal
Smith, NJ:
Maple Hlth Grp, New York, NY USA
Teixeira-Pinto, A:
Univ Sydney, Sch Publ Hlth, Fac Med & Hlth, Sydney, NSW, Australia
Green Submitted, gold, Green Published
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