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Impacts of remdesivir on dynamics and efficacy stratified by the severity of COVID- 19: a simulated two-arm controlled study
dc.contributor.author | Lin, Ting-Yu et al. | |
dc.date.accessioned | 2020-06-10T17:14:19Z | |
dc.date.available | 2020-06-10T17:14:19Z | |
dc.date.issued | 2020-05-22 | |
dc.identifier.uri | https://doi.org/10.1101/2020.05.17.20104711 | en_US |
dc.identifier.uri | https://hdl.handle.net/20.500.12663/1736 | |
dc.description.abstract | Background: The impact of remdesivir on length of stay of hospitalization, high-risk state, and death stratified by the severity of COVID-19 at enrollment is controversial. Methods: We applied a simulated two-arm controlled study design to the data on compassionate use of remdesivir as a secondary analysis. Dynamics of risk states and death from COVID-19 patients defined by the six-point disease severity recommended by the WHO R&D and the time to discharge from hospital were used to evaluate the efficacy of remdesivir treatment compared with standard care. Results: Stratified by the risk state at enrollment, low-risk patients exhibited the highest efficacy of remdesivir in reducing subsequent progression to high-risk state by 67% (relative risk (RR)=0.33,95% CI: 0.30-0.35) and further to death by 55% (RR=0.45, 95%CI: 0.39-0.50). For the medium-risk patients, less but still statistically significant efficacy results were noted in reducing progression to high-risk state by 52% (RR=0.48, 95% CI: 0.45-0.51) and further to death by 40% (RR=0.60, 95% CI:0.54-0.66). High-risk state patients treated with remdesivir led to a 25% statistically significant reduction in death (RR=0.75, 95% CI: 0.69-0.82). Regarding the outcome of discharge, remdesivir treatment was most effective for medium-risk patients at enrollment (RR: 1.41, 95% CI: 1.35-1.47) followed by high- (RR=1.34, 95% CI: 1.27-1.42) and low-risk patients (RR=1.28, 95% CI: 1.25-1.31). Conclusion: Our results with a simulated two-arm controlled study have provided a new insight into the precision treatment of remdesivir for COVID-19 patients based on risk-stratified efficacy. | en_US |
dc.language | English | en_US |
dc.subject | Coronavirus | en_US |
dc.subject | COVID-19 | en_US |
dc.subject | Remdesivir | en_US |
dc.subject | Controlled Clinical Trial | en_US |
dc.subject | Coronavirus Infections | en_US |
dc.title | Impacts of remdesivir on dynamics and efficacy stratified by the severity of COVID- 19: a simulated two-arm controlled study | en_US |
eihealth.country | Global (WHO/OMS) | en_US |
eihealth.category | Candidate therapeutics RD | en_US |
eihealth.type | Published Article | en_US |
eihealth.maincategory | Save Lives / Salvar Vidas | en_US |
dc.relation.ispartofjournal | medRxiv | en_US |
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