Clinical outcomes of early remdesivir administration in hospitalized patients at high risk for severe COVID-19 during the Omicron wave
Abstract Background Early remdesivir administration in high-risk patients with coronavirus disease 2019 (COVID-19) is known to be effective in preventing the progression to severe disease. However, the effect of early remdesivir administration on Omicron variants, which are known to have decreased s...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-02-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-025-10585-3 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1825197675820089344 |
|---|---|
| author | Yeon Ju La Won Sup Oh Changhyup Kim Myoung-nam Lim Yong Duk Jeon |
| author_facet | Yeon Ju La Won Sup Oh Changhyup Kim Myoung-nam Lim Yong Duk Jeon |
| author_sort | Yeon Ju La |
| collection | DOAJ |
| description | Abstract Background Early remdesivir administration in high-risk patients with coronavirus disease 2019 (COVID-19) is known to be effective in preventing the progression to severe disease. However, the effect of early remdesivir administration on Omicron variants, which are known to have decreased severity, remains unclear. Methods This study aimed to analyze the effects of early remdesivir administration during the Omicron wave in hospitalized patients. Electronic medical records of hospitalized patients with confirmed COVID-19 between February 2022 and February 2023 were reviewed. We included patients aged ≥ 18 years who had symptom onset within 7 days and had at least one risk factor for disease progression at the time of diagnosis. We compared the clinical outcomes between the early remdesivir administration group and the group not administered early remdesivir. The primary outcome was all-cause mortality within 28 days and the secondary outcome was the need for oxygen supplementation within 28 days. Multivariable analysis was conducted to assess risk factors for all-cause mortality and the need for oxygen supplementation. Results A total of 286 patients were enrolled, including 88 in the early remdesivir administration group and 198 in the control group. Clinical outcomes, including all-cause mortality (3.4% vs. 6.1%, P = 0.556) and need for oxygen supplementation (15.9% vs. 14.6%, P = 0.783) within 28 days, were not significantly different between the two groups. Age (HR, 1.061; 95% CI: 1.002, 1.124; P = 0.043), BMI (HR, 0.849; 95% CI: 0.725, 0.994; P = 0.041), and malignancy (HR, 4.619; 95% CI: 1.618, 13.189; P = 0.004) were identified as independent factors associated with all-cause mortality. Additionally, BMI (OR, 0.908; 95% CI, 0.824, 1.000; P = 0.049) and vaccination with more than three doses (OR, 0.412; 95% CI, 0.202, 0.839; P = 0.015) were independent factors associated with the need for oxygen supply. Early remdesivir administration was not significantly associated with all-cause mortality (HR, 0.393; 95% CI: 0.109, 1.417; P = 0.154) or the need for oxygen supplementation (OR, 0.823; 95% CI: 0.389, 1.740; P = 0.610). Conclusions In our study, early remdesivir administration was not associated with preventing progression to severe disease when used as previously indicated during the Omicron wave. Considering the decline in the severity of the Omicron variant and the increased vaccination rate reported in previous studies, further studies are needed to establish new indications for the use of early remdesivir in the Omicron variant. |
| format | Article |
| id | doaj-art-cda63dce2f58409cae76b1417118fb6b |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-cda63dce2f58409cae76b1417118fb6b2025-02-09T12:14:47ZengBMCBMC Infectious Diseases1471-23342025-02-012511710.1186/s12879-025-10585-3Clinical outcomes of early remdesivir administration in hospitalized patients at high risk for severe COVID-19 during the Omicron waveYeon Ju La0Won Sup Oh1Changhyup Kim2Myoung-nam Lim3Yong Duk Jeon4Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of MedicineDepartment of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of MedicineDepartment of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of MedicineBiomedical Research Institute, Kangwon National University HospitalDepartment of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of MedicineAbstract Background Early remdesivir administration in high-risk patients with coronavirus disease 2019 (COVID-19) is known to be effective in preventing the progression to severe disease. However, the effect of early remdesivir administration on Omicron variants, which are known to have decreased severity, remains unclear. Methods This study aimed to analyze the effects of early remdesivir administration during the Omicron wave in hospitalized patients. Electronic medical records of hospitalized patients with confirmed COVID-19 between February 2022 and February 2023 were reviewed. We included patients aged ≥ 18 years who had symptom onset within 7 days and had at least one risk factor for disease progression at the time of diagnosis. We compared the clinical outcomes between the early remdesivir administration group and the group not administered early remdesivir. The primary outcome was all-cause mortality within 28 days and the secondary outcome was the need for oxygen supplementation within 28 days. Multivariable analysis was conducted to assess risk factors for all-cause mortality and the need for oxygen supplementation. Results A total of 286 patients were enrolled, including 88 in the early remdesivir administration group and 198 in the control group. Clinical outcomes, including all-cause mortality (3.4% vs. 6.1%, P = 0.556) and need for oxygen supplementation (15.9% vs. 14.6%, P = 0.783) within 28 days, were not significantly different between the two groups. Age (HR, 1.061; 95% CI: 1.002, 1.124; P = 0.043), BMI (HR, 0.849; 95% CI: 0.725, 0.994; P = 0.041), and malignancy (HR, 4.619; 95% CI: 1.618, 13.189; P = 0.004) were identified as independent factors associated with all-cause mortality. Additionally, BMI (OR, 0.908; 95% CI, 0.824, 1.000; P = 0.049) and vaccination with more than three doses (OR, 0.412; 95% CI, 0.202, 0.839; P = 0.015) were independent factors associated with the need for oxygen supply. Early remdesivir administration was not significantly associated with all-cause mortality (HR, 0.393; 95% CI: 0.109, 1.417; P = 0.154) or the need for oxygen supplementation (OR, 0.823; 95% CI: 0.389, 1.740; P = 0.610). Conclusions In our study, early remdesivir administration was not associated with preventing progression to severe disease when used as previously indicated during the Omicron wave. Considering the decline in the severity of the Omicron variant and the increased vaccination rate reported in previous studies, further studies are needed to establish new indications for the use of early remdesivir in the Omicron variant.https://doi.org/10.1186/s12879-025-10585-3COVID-19OmicronEarly remdesivirSeverity |
| spellingShingle | Yeon Ju La Won Sup Oh Changhyup Kim Myoung-nam Lim Yong Duk Jeon Clinical outcomes of early remdesivir administration in hospitalized patients at high risk for severe COVID-19 during the Omicron wave BMC Infectious Diseases COVID-19 Omicron Early remdesivir Severity |
| title | Clinical outcomes of early remdesivir administration in hospitalized patients at high risk for severe COVID-19 during the Omicron wave |
| title_full | Clinical outcomes of early remdesivir administration in hospitalized patients at high risk for severe COVID-19 during the Omicron wave |
| title_fullStr | Clinical outcomes of early remdesivir administration in hospitalized patients at high risk for severe COVID-19 during the Omicron wave |
| title_full_unstemmed | Clinical outcomes of early remdesivir administration in hospitalized patients at high risk for severe COVID-19 during the Omicron wave |
| title_short | Clinical outcomes of early remdesivir administration in hospitalized patients at high risk for severe COVID-19 during the Omicron wave |
| title_sort | clinical outcomes of early remdesivir administration in hospitalized patients at high risk for severe covid 19 during the omicron wave |
| topic | COVID-19 Omicron Early remdesivir Severity |
| url | https://doi.org/10.1186/s12879-025-10585-3 |
| work_keys_str_mv | AT yeonjula clinicaloutcomesofearlyremdesiviradministrationinhospitalizedpatientsathighriskforseverecovid19duringtheomicronwave AT wonsupoh clinicaloutcomesofearlyremdesiviradministrationinhospitalizedpatientsathighriskforseverecovid19duringtheomicronwave AT changhyupkim clinicaloutcomesofearlyremdesiviradministrationinhospitalizedpatientsathighriskforseverecovid19duringtheomicronwave AT myoungnamlim clinicaloutcomesofearlyremdesiviradministrationinhospitalizedpatientsathighriskforseverecovid19duringtheomicronwave AT yongdukjeon clinicaloutcomesofearlyremdesiviradministrationinhospitalizedpatientsathighriskforseverecovid19duringtheomicronwave |