- For patients with COVID-19 who were mechanically ventilated in the ICU, remdesivir, administered under compassionate use approval, was linked to improved survival in this cohort study.
Why this matters
- This study examined the effect of remdesivir in the most severely ill patients with COVID-19, who received it under compassionate use approval.
- Retrospective cohort study in an Italian ICU of patients treated with remdesivir (n=25) under compassionate use compared with patients who had not received the drug (n=26).
- Remdesivir dose was 200 mg intravenously (IV) on day 1 of a 10-day course, followed by 100 mg IV for the remaining 9 days.
- Funding: No external funds.
- Median age of patients was 67 (interquartile range [IQR], 59-75.5) years; 92.2% were male.
- Median follow-up, 52 (46-57) days.
- Symptom onset was 10 (IQR, 8-12) days before ICU admission.
- Overall mortality: 74.5%.
- Mortality was lower with remdesivir (56%) vs without it (92.3%; P<.001>
- Upon multivariate analysis, high comorbidity on the Charlson Comorbidity Index was the only factor associated with higher mortality (OR, 1.184; P=.020).
- Receipt of remdesivir was the only factor associated with better survival (OR, 3.506; P<.001>
- Small numbers of patients in each group.
- Lack of clinician blinding.
- Nonrandomized design.
- Single center.
- Compassionate use of remdesivir likely introduced selection bias.
- Observational; residual confounding likely.