SARS-CoV-2 viral load is linked to remdesivir efficacy in severe Covid-19 admitted to intensive care.
Humans
Adenosine Monophosphate
/ analogs & derivatives
Alanine
/ analogs & derivatives
Male
Female
Viral Load
/ drug effects
Aged
SARS-CoV-2
/ drug effects
Middle Aged
COVID-19 Drug Treatment
COVID-19
/ virology
Antiviral Agents
/ therapeutic use
Retrospective Studies
Treatment Outcome
Critical Care
Intensive Care Units
Severity of Illness Index
Antigen testing
Intensive care
Real-time PCR
Remdesivir
SARS-CoV-2
Viral load
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
06 Sep 2024
06 Sep 2024
Historique:
received:
11
04
2024
accepted:
29
08
2024
medline:
7
9
2024
pubmed:
7
9
2024
entrez:
6
9
2024
Statut:
epublish
Résumé
Remdesivir therapy has been declared as efficient in the early stages of Covid-19. Of the 339 patients (males 55.8%, age 71(59;77) years) with a detectable viral load, 140 were treated with remdesivir (of those 103 in the ICU and 57 immunosuppressed) and retrospectively compared with 199 patients (of those 82 in the ICU and 28 immunosuppressed) who were denied therapy due to advanced Covid-19. The viral load was estimated by detecting nucleocapsid antigen in serum (n = 155, median 217(28;1524)pg/ml), antigen in sputum (n = 18, COI 18(4.6;32)), nasopharyngeal antigen (n = 44, COI 17(8;35)) and the real-time PCR (n = 122, Ct 21(18;27)). After adjustment for confounders, patients on remdesivir had better 12-month survival (HR 0.66 (0.44;0.98), p = 0.039), particularly when admitted to the ICU (HR 0.49 (0.29;0.81), p = 0.006). For the immunocompromised patients, the difference did not reach statistical significance (HR 0.55 (0.18;1.69), p = 0.3). The other most significant confounders were age, ICU admission, mechanical ventilation, leukocyte/lymphocyte ratio, admission creatinine and immunosuppression. The impact of monoclonal antibodies or previous vaccinations was not significant. Despite frequent immune suppression including haemato-oncology diseases, lymphopenia, and higher inflammatory markers in the remdesivir group, the results support remdesivir administration with respect to widely available estimates of viral load in patients with high illness severity.
Identifiants
pubmed: 39242658
doi: 10.1038/s41598-024-71588-9
pii: 10.1038/s41598-024-71588-9
doi:
Substances chimiques
remdesivir
3QKI37EEHE
Adenosine Monophosphate
415SHH325A
Alanine
OF5P57N2ZX
Antiviral Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
20825Subventions
Organisme : Agentura Pro Zdravotnický Výzkum České Republiky
ID : AZV NU22-B-147
Organisme : Agentura Pro Zdravotnický Výzkum České Republiky
ID : AZV NU22-B-147
Organisme : Agentura Pro Zdravotnický Výzkum České Republiky
ID : AZV NU22-B-147
Organisme : Agentura Pro Zdravotnický Výzkum České Republiky
ID : AZV NU22-B-147
Organisme : Agentura Pro Zdravotnický Výzkum České Republiky
ID : AZV NU22-B-147
Organisme : Agentura Pro Zdravotnický Výzkum České Republiky
ID : AZV NU22-B-147
Organisme : Agentura Pro Zdravotnický Výzkum České Republiky
ID : AZV NU22-B-147
Organisme : Agentura Pro Zdravotnický Výzkum České Republiky
ID : AZV NU22-B-147
Organisme : Agentura Pro Zdravotnický Výzkum České Republiky
ID : AZV NU22-B-147
Organisme : Agentura Pro Zdravotnický Výzkum České Republiky
ID : AZV NU22-B-147
Organisme : Agentura Pro Zdravotnický Výzkum České Republiky
ID : AZV NU22-B-147
Organisme : Agentura Pro Zdravotnický Výzkum České Republiky
ID : AZV NU22-B-147
Informations de copyright
© 2024. The Author(s).
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