Treatment May Hasten Viral Clearance in Specific Subgroups Hospitalized With COVID-19

Treatment with remdesivir was associated with decreased time to viral clearance in specific patient subgroups with COVID-19, according to a study published in Drug Design, Development and Therapy.

The retrospective, matched-cohort study included 648 adults hospitalized with COVID-19 pneumonia between February 25, 2020, and to April 12, 2021, at San Raffaele Hospital, a designated COVID-19 hub in Milan, Italy. Among the patients, 216 received remdesivir treatment, and 432 controls did not. Researchers investigated the time to viral clearance within 30 days of hospital discharge in patients with and without remdesivir treatment. Patients were matched 1:2 for age, sex, and PaO₂/FiO₂ values at admission. A measure of oxygenation, PaO₂/FiO₂ represents the ratio of arterial partial pressure of oxygen to the percentage of oxygen supplied.

Some 490 patients, or 75.6% of those in the study, achieved viral clearance within 30 days of discharge. Younger age and a higher PaO₂/FiO₂ ratio at admission were associated with viral clearance, researchers reported. The median time to viral clearance was 25 days.

The time to viral clearance was similar with and without remdesivir treatment overall, according to the study. However, when researchers looked at certain subgroups of patients, differences emerged. In short, patients who were younger or with a higher baseline PaO₂/FiO₂ ratio showed benefit with remdesivir.

“[T]reatment with remdesivir was associated with a decreased time to viral clearance in those with a PaO₂/FiO₂ ≤200 mmHg at admission and ≤65 years of age, when compared to controls,” they wrote. “Younger patients have a more efficient immune response compared to older patients. In this population characterized by a lower nasopharyngeal viral load and faster viral decay, the antiviral activity of remdesivir may further facilitate viral clearance.”

Reference:
Spagnuolo V, Voarino M, Tonelli M, et al. Impact of remdesivir on SARS-CoV-2 clearance in a real-life setting: a matched-cohort study. Drug Des Devel Ther. 2022;16:3645-3654. doi:10.2147/DDDT.S369473