Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan.
Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan.
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DOI：
10.1016/j.ijid.2022.02.039
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发表时间：
2022-05
期刊：
影响因子：
--
通讯作者：
Ohmagari N
中科院分区：
文献类型：
--
作者：
Tsuzuki S;Hayakawa K;Uemura Y;Shinozaki T;Matsunaga N;Terada M;Suzuki S;Asai Y;Kitajima K;Saito S;Yamada G;Shibata T;Kondo M;Izumi K;Hojo M;Mizoue T;Yokota K;Nakamura-Uchiyama F;Saito F;Sugiura W;Ohmagari N
目的：评价瑞希韦早期治疗非重症新冠肺炎的疗效。尽管几个随机对照试验已经比较了雷米希韦和安慰剂的有效性，但关于其在非重症新冠肺炎病例的早期阶段的效果的证据有限。我们使用日本新冠肺炎登记处评估了瑞希韦在非重症新冠肺炎早期的有效性，该登记处是日本新冠肺炎住院患者的全国性登记。在不需要辅助氧疗的患者中，采用三步处理(克隆、审查和加权)方法比较了两种方案(入院后4天内开始雷米德韦治疗和住院期间不开始雷米希韦治疗)。主要结果是在住院期间需要补充氧气。次要结果是30天的住院死亡率和有创性机械通气或体外膜氧合(IMV/ECMO)的风险。12487例患者的数据符合我们的纳入标准。“Start redesivir”方案显示出较低的补充氧量风险(危险比[HR]：0.850，95%可信区间[CI]：0.798-0.906，p值&0.001)。两种方案的30d住院死亡率和引入IMV/ECMO的风险差异均无统计学意义(HR分别为1.04和0.983，95%CI分别为0.980~1.09和0.906~1.07，P值分别为0.210和0.678)。雷美西韦可降低新冠肺炎早期住院期间的氧耗量风险，但对临床转归和减少内膜静脉/体外膜氧合需氧量无积极作用。
To evaluate the effectiveness of remdesivir in the early stage of nonsevere COVID-19. Although several randomized controlled trials have compared the effectiveness of remdesivir with that of a placebo, there is limited evidence regarding its effect in the early stage of nonsevere COVID-19 cases. We evaluated the effectiveness of remdesivir in the early stage of nonsevere COVID-19 using the COVID-19 Registry Japan, a nationwide registry of hospitalized patients with COVID-19 in Japan. Two regimens (“start remdesivir” therapy within 4 days from admission versus no remdesivir during hospitalization) among patients without the need for supplementary oxygen therapy were compared by a 3-step processing (cloning, censoring, and weighting) method. The primary outcome was a supplementary oxygen requirement during hospitalization. Secondary outcomes were 30-day in-hospital mortality and the risk of invasive mechanical ventilation or extracorporeal membrane oxygenation (IMV/ECMO). The data of 12,487 cases met our inclusion criteria. The “start remdesivir” regimen showed a lower risk of supplementary oxygen requirement (hazard ratio [HR]: 0.850, 95% confidence interval [CI]: 0.798–0.906, p value < 0.001). Both 30-day in-hospital mortality and risk of IMV/ECMO introduction were not significantly different between the 2 regimens (HRs: 1.04 and 0.983, 95% CI: 0.980–1.09 and 0.906–1.07, p values: 0.210 and 0.678, respectively). Remdesivir might reduce the risk of oxygen requirement during hospitalization in the early stage of COVID-19; however, it had no positive effect on the clinical outcome and reduction in IMV/ECMO requirement.
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DOI：
10.35772/ghm.2020.01106
发表时间：
2021-01-01
期刊：
GLOBAL HEALTH & MEDICINE
影响因子：
--
作者：
Saito, Sho;Hayakawa, Kayoko;Ohmagari, Norio
通讯作者：
Ohmagari, Norio
影响因子：
7.2
作者：
Hernan, Miguel A.;Sauer, Brian C.;Shrier, Ian
通讯作者：
Shrier, Ian
影响因子：
105.7
作者：
Petrilli, Christopher M.;Jones, Simon A.;Horwitz, Leora I.
通讯作者：
Horwitz, Leora I.
影响因子：
1.9
作者：
Robins, JM;Finkelstein, DM
通讯作者：
Finkelstein, DM
影响因子：
120.7
作者：
Spinner, Christoph D.;Gottlieb, Robert L.;Marty, Francisco M.
通讯作者：
Marty, Francisco M.