Clinical outcomes of remdesivir in patients with COVID-19 infection: An observational study from a tertiary care hospital in Pakistan

Abstract

Background: The primary objective was to assess the change in oxygenation status of patients after remdesivir treatment. Material and Methods: This retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi from September to December 2020. All patients aged >18 years admitted with a positive reverse transcriptase-polymerase chain reaction for COVID-19 were included. Infection severity was subcategorized into two groups (moderate-to-severe and critical). We compared oxygenation status and assisted ventilation before and after remdesivir treatment. An analysis of outcomes between the groups was conducted using chi squares and the student t-test at a significance level of <0.05. Results: We had 213 COVID-19 patients, of whom 114 (53.5%) received remdesivir during their hospital stay. 69 (60.5%) patients were male and the mean age was 52±12 years. 56 patients (49.1%) had moderate-to-severe infections. 21 out of 56 patients (37.5%) with moderate-to-severe COVID-19 infection while 47 out of 58 patients (81%) with critical COVID-19 required oxygen following remdesivir treatment (p-value: <0.001). Out of 58 critical COVID-19 patients, 46 patients (79.3%) were on non-invasive ventilation and 12 patients (20.7%) were on invasive ventilation prior to remdesivir therapy. 22 out of 46 patients (47.8%) recovered from non-invasive ventilation after remdesivir treatment (p-value: <0.001). 15 patients had mortality (13.1%) while the mean length of hospital stay with moderate-to-severe COVID-19 infection was 6.8 days and with critical COVID-19 infection was 11.3 days. Conclusion: The study emphasizes that remdesivir was found to be clinically beneficial in patients with moderate-to-severe COVID-19 infection. Besides improving oxygenation status, it also reduced mortality and shortened hospital stays. Keywords: Antiviral drug, COVID-19, Hypoxia, Noninvasive ventilation, Severe acute respiratory distress syndrome