Lower mortality risk associated with remdesivir + dexamethasone versus dexamethasone alone for the treatment of patients hospitalized for COVID-19

Clinical Infectious Diseases, Journal Year: 2024, Volume and Issue: 80(1), P. 63 - 71

Published: Sept. 20, 2024

Treatment guidelines were developed early in the pandemic when much about coronavirus disease 2019 (COVID-19) was unknown. Given evolution of severe acute respiratory syndrome 2 (SARS-CoV-2), real-world data can provide clinicians with updated information. The objective this analysis to assess mortality risk patients hospitalized for COVID-19 during Omicron period receiving remdesivir + dexamethasone versus alone. A large, multicenter US hospital database used identify adult a primary discharge diagnosis flagged as "present-on-admission" and treated or alone between December 2021 April 2023. Patients matched using 1:1 propensity score matching stratified by baseline oxygen requirements. Cox proportional hazards model time 14- 28-day in-hospital all-cause mortality. total 33 037 matched, most ≥65 years old (72%), White (78%), non-Hispanic (84%). Remdesivir associated lower across all requirements at 14-days (no supplemental charges: adjusted hazard ratio [95% confidence interval {CI}]: 0.79 [.72-.87], low flow oxygen: 0.70 [.64-.77], high oxygen/non-invasive ventilation: 0.69 [.62-.76], invasive mechanical ventilation/extracorporeal membrane (IMV/ECMO): 0.78 [.64-.94]), similar results 28-days. significant reduction compared levels support, including IMV/ECMO. However, use still has clinical practice uptake. In addition, these suggest need update existing guidelines.

Language: Английский

True DisCoVeRy of COVID-19 Disease Burden Versus Speculated Antiviral Cardiovascular Risk Requires a Control Group

Clinical Infectious Diseases, Journal Year: 2024, Volume and Issue: 79(2), P. 392 - 394

Published: March 29, 2024

Imagine if data on wild-type SARS-CoV-2 viral infection was submitted to a regulatory agency for safety review: the attendant Covid-19 disease would prompt alerts and red flags.Beyond respiratory disease, its direct indirect sequelae are multisystem in nature, with cardiovascular risks, particularly manifest immunologically naïve populations.The literature is now rife cases of autonomic insufficiency, bradycardia, multiple types tachycardias, thromboembolic events, myocarditis resulting from circulating virus ---------

Language: Английский