The following is a summary of “Real-world evaluation of early remdesivir in high-risk COVID-19 outpatients during Omicron including BQ.1/BQ.1.1/XBB.1.5,” published in the August 2024 issue of Infectious Disease by Molina et al.
Researchers conducted a retrospective study using real-world data to assess remdesivir’s impact on preventing 28-day hospitalization in mild-to-moderate COVID-19 outpatients during the Omicron BA.1/BA.5/BQ.1/BQ.1.1/XBB.1.5 period.
They conducted a propensity-matched, non-hospitalized adults with SARS-CoV-2 infection (April 7, 2022, to February 7, 2023). Data from electronic healthcare records of a primary health system in Colorado were combined with statewide vaccination and mortality statistics. Patients with either a positive SARS-CoV-2 test or outpatient remdesivir treatment were included.
Patients were excluded if other SARS-CoV-2 treatments or a positive test more than 7 days before remdesivir. The primary outcome measured was all-cause hospitalization within 28 days. Secondary outcomes were 28-day COVID-related hospitalization and 28-day all-cause mortality.
The results showed that of 29,270 patients with SARS-CoV-2 infection, 1,252 patients treated with remdesivir were matched with 2,499 untreated patients. Remdesivir was linked to a reduced 28-day all-cause hospitalization rate (1.3% vs. 3.3%, aHR 0.39 [95% CI 0.23–0.67], P<0.001) compared to no treatment. The 28-day all-cause mortality was numerically lower in patients with remdesivir treatment (0.1% vs. 0.4%; aOR 0.32 [95% CI 0.03–1.40]). The benefit of remdesivir on 28-day all-cause hospitalization was consistent across Omicron variants, with aOR (95% CI) values of BA.2/BA2.12.1 (0.77 [0.19–2.41]), BA.4/5 (0.50 [0.50–1.01]), and BQ.1/BQ.1.1/XBB.1.5 (0.21 [0.08–0.57]).
Investigators concluded that remdesivir treatment was associated with a reduced risk of hospitalization compared to no therapy among SARS-CoV-2 outpatients during recent Omicron surges, supporting current National Institutes of Health guidelines.
Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09708-z
