Impact of Early Remdesivir Treatment in Severe Covid-19 Pneumonia in ICU Patients

Abstract

Background: This study was conducted with the main objective to study the effect of early treatment of patients tested COVID-19 positive with remdesivir and to study time to clinical improvement and recovery from clinical symptoms of severe Covid-19 infection. Materials & Methods: This is an institutional-based case-control study conducted on patients admitted at Bidar Institute of Medical Sciences for a period of 2 months. Hospitalized subjects who wereCOVID-19 pneumonia infection confirmed were included. Detailed history, physical examination and necessary investigations were conducted, and the data was collected using a pretested proforma. Subjects were evaluated by physical inspection as well as by documentation of concomitant medications, respiratory status & adverse events. On day 1, 3, 5, 8, 10, & 14, samples of blood were collected for the complete blood count analysis and also for creatinine as well as liver aminotransferase measurements. The subjects’ clinical status was evaluated on a daily basis on a 6-point ordinal scale from day one through fourteen or until discharge.Results: The majority of the subjects treated with remdesivir did not have comorbidities. Median age and duration before remdesivir treatment were 6 days, with median ALT, AST and creatinine clearance was found to be IQR 7, 12 and 39. In our study, the commonest negative outcomes observed were (6%), deranged liver function (4%), hypotension (3%), hypokalaemia (3%), acute respiratory failure (2%), acute kidney injury (2%) and pneumothorax (1%). The most common morbidities observed in our study were diabetes (12%) asthmatic (10%), COPD and combination of diabetes and HTN (8%), diabetic COPD (5%), COPD and hypertension (2%) and diabetic COPD (1%). 25% of study subjects were died, while 75% of study subjects were discharged after recovery. Conclusion: Our study findings delineated the importance of early remdesivir treatment initiation and resulted in clear mortality benefit of ICU subjects suffering severely from COVID-19 pneumonia.