Improved Survival Among Hospitalized Patients With Coronavirus Disease 2019 (COVID-19) Treated With Remdesivir and Dexamethasone. A Nationwide Population-Based Cohort Study
Improved Survival Among Hospitalized Patients With Coronavirus Disease 2019 (COVID-19) Treated With Remdesivir and Dexamethasone. A Nationwide Population-Based Cohort Study
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DOI：
10.1093/cid/ciab536
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发表时间：
2021-12-01
影响因子：
11.8
通讯作者：
Christensen, Hanne Rolighed
中科院分区：
文献类型：
--
作者：
Benfield, Thomas;Bodilsen, Jacob;Christensen, Hanne Rolighed
背景。在现实环境中，接受瑞德西韦和地塞米松治疗的患者中，2019年中重度冠状病毒病（COVID-19）的结局数据有限。我们试图比较标准护理（SOC）单独与SOC加瑞德西韦和地塞米松的有效性。研究了2020年2月至12月期间因COVID-19住院的两组以人群为基础的全国队列。采用治疗加权逆概率（ITPW） logistic回归分析比较30天内死亡和机械通气需求（MV），并以95%可信区间（CI）的优势比（OR）表示。1694例接受瑞德西韦和地塞米松加SOC治疗的患者的30天死亡率为12.6%，而1053例单独接受SOC治疗的患者的30天死亡率为19.7%。与单独接受SOC的患者相比，接受瑞德西韦和地塞米松治疗的患者30天死亡率的加权OR为0.47 （95% CI: 0.38 - 0.57）。同样，进展为MV的患者也减少了（OR 0.36; 95% CI: 0.29 - 0.46）。与2月至5月的治疗相比，6月至12月期间使用瑞德西韦和地塞米松治疗中重度COVID-19可降低30天死亡率和MV需求。
Background. There are limited data on outcomes of moderate to severe coronavirus disease 2019 (COVID-19) among patients treated with remdesivir and dexamethasone in a real-world setting. We sought to compare the effectiveness of standard of care (SOC) alone versus SOC plus remdesivir and dexamethasone.Methods. Two population-based nationwide cohorts of individuals hospitalized with COVID-19 during February through December 2020 were studied. Death within 30 days and need of mechanical ventilation (MV) were compared by inverse probability of treatment weighted (ITPW) logistic regression analysis and shown as odds ratio (OR) with 95% confidence interval (CI).Results. The 30-days mortality rate of 1694 individuals treated with remdesivir and dexamethasone in addition to SOC was 12.6% compared to 19.7% for 1053 individuals receiving SOC alone. This corresponded to a weighted OR of 30-day mortality of 0.47 (95% CI:.38-.57) for patients treated with remdesivir and dexamethasone compared to patients receiving SOC alone. Similarly, progression to MV was reduced (OR 0.36; 95% CI:.29-.46).Conclusions. Treatment of moderate to severe COVID-19 during June through December that included remdesivir and dexamethasone was associated with reduced 30-day mortality and need of MV compared to treatment in February through May.