15 Jul Remdesivir: Study Finds No Improved Survival in Hospitalized COVID-19 Patients
MedicalResearch.com Interview with:
Michael Ohl, MD, MSPH
Associate Professor of Internal Medicine-Infectious Diseases
Roy J. and Lucille A. Carver College of Medicine
University of Iowa
MedicalResearch.com: What is the background for this study?
Response: The background is that remdesivir was approved for treatment in 2020 largely based on the results of the Adaptive COVID-19 Treatment Trial 1 (ACTT-1), which found that remdesivir treatment was associated with more rapid recovery from illness among people hospitalized with COVID-19. The intention was that – even if remdesivir did not lead to substantial improvements in survival- it could help people to recover more quickly and be discharged from hospital sooner, potentially opening scare hospital pends to treat more patients during the pandemic.
MedicalResearch.com: What are the main findings?
Response: Our study had the unexpected finding that remdesivir treatment was not associated with improved survival among people hospitalized with COVID-19, but it was associated with a three day increase in the median duration of hospital stay. Examination of the timing of remdesivir treatment and hospital discharge suggested that clinicians were keeping some patients in the hospital simply to complete remdesivir courses, even thought the patients may otherwise have been ready to leave the hospital. The implication is that routine use of remdesivir may have led to an unintended consequence of increased use of hospital beds during the COVID-19 pandemic, without improving outcomes.
MedicalResearch.com: What should readers take away from your report?
Response: We believe it remains reasonable to use remdesivir in selected patients following the the NIH and Infectious Disease Society of America guidelines for COVID-19 treatment , but clinicians should avoid admitting people or keeping people in hospital solely to receive remdesivir if they do not meet other criteria for hospitalization.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Our findings were from Summer and Fall of 2020, and COVID-19 treatment has evolved. There is need for studies to determine if remdesivir use is still associated with longer length of hospital stay now, and in settings outside VA. We need to get the message out to clinicians that we should not keep people with COVID-19 in hospital solely to give remdesivir treatment, if they otherwise do not have reason to be in the hospital.
No disclosure related to this paper. I performed consulting for Gilead Science in 2018 on topics unrelated to this study
Ohl ME, Miller DR, Lund BC, et al. Association of Remdesivir Treatment With Survival and Length of Hospital Stay Among US Veterans Hospitalized With COVID-19. JAMA Netw Open. 2021;4(7):e2114741. doi:10.1001/jamanetworkopen.2021.14741
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