Remdesivir treatment in hospitalized patients affected by COVID-19 pneumonia: a case-control study

Background: to date the optimal antiviral treatment against severe coronavirus disease 2019 (COVID-19) has not been proven; remdesivir is a promising drug with in vitro activity against several virus, but in COVID-19 the clinical results are currently not definitive. Methods: in this retrospective observational study we analyzed the clinical outcomes (survival analysis, efficacy and safety) in a group of hospitalized patients with COVID-19 treated with remdesivir in comparison with a control group of patients treated with other antiviral or supportive therapies. Results: we included 163 patients treated with remdesivir and 403 subjects in the control group; the baseline characteristics were similar in the two groups; mortality rate was higher in control group (24.8% vs 2.4%, p<0.001), the risk of intensive-care-unit (ICU) admission was higher in control group (17.8% vs 9.8%, p=0.008); hospitalization time was significantly lower in patients treated with remdesivir (9.5 vs 12.5 days, p<0.001). The safety of remdesivir was good and no significant adverse events were reported. In multivariate analysis the remdesivir treatment was independently associated with a 34% lower mortality rate (OR=0.669; p=0.014). Conclusions: in this analysis the treatment with remdesivir was associated with lower mortality, lower rate of ICU admission, shorter time of hospitalization. No adverse events were observed. This promising antiviral treatment should also be confirmed by other studies. This article is protected by copyright. All rights reserved.