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Does Earlier Remdesivir Initiation Improve COVID-19 Recovery Time?

One study, presented at the Critical Care Congress, found that initiating remdesivir (Veklury) earlier did not significantly reduce the recovery time of hospitalized COVID-19 patients.

Remdesivir was approved by the US Food and Drug Administration (FDA) to treat hospitalized COVID-19 patients. However, one study, presented virtually at the 51st Critical Care Congress, questioned whether it was truly effective.

Remdesivir is the current standard of care for hospitalized COVID-19 patients. In January, the FDA expanded their approval to allow remdesivir to be administered in qualified outpatient settings to treat non-hospitalized adult and adolescent persons at high risk of severe or fatal COVID-19.

The study, presented yesterday by lead author Marissa Campagna, PharmD, RPh, investigated whether early remdesivir initiation from time of COVID-19 diagnosis improved recovery time.

The retrospective analysis reviewed adult COVID-19 patients discharged from August 1-October 31, 2020. Data collected included patient demographics, comorbidities, microbiology, oxygen requirements, and concomitant COVID-19 treatment therapies.

A total of 444 patients received remdesivir therapy and met the inclusion criteria for the final study cohort. The majority of patients (72.9%) received remdesivir within 0-3 days of COVID-19 diagnosis. The cohort was 49.8% male and 84.7% white, with an average age of 70.5 years. Upon presentation to the hospital, 55.4% required nasal cannula. At 95.9%, the vast majority had at least 1 comorbidity; 65.5% had cardiovascular disease and 57.0% were obese.

The primary endpoint of the study was time to clinical stability from PCR-testing positive for COVID-19 to initiation of remdesivir: 0-3, 4-6, 7-10, and 11+ days. The average time to recovery was 7.5 days for the 0-3 day group, 11 days in the 4-6 day group, 8 days in the 7-10 day group, and 5 days in the 11+ day group. Thus, there was no statistically significant difference between the 4 groups (P=0.19).

The investigators concluded that initiating remdesivir earlier did not significantly reduce time to recovery. They recommended further study into how useful, if at all, remdesivir is in treating hospitalized COVID-19 patients.

The study, “Evaluation of Early Remdesivir Initiation in COVID-19 Patients From Time of Confirmed Diagnosis,” was presented on April 18, 2022, during the 51st Critical Care Congress.