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. 2023 Oct 17;15(10):2101.
doi: 10.3390/v15102101.

Use of Remdesivir in Patients Hospitalized for COVID-19 Pneumonia: Effect on the Hypoxic and Inflammatory State

Alessandro Libra  1 , Nicola Ciancio  1 , Gianluca Sambataro  1 , Enrico Sciacca  1 , Giuseppe Muscato  1 , Andrea Marino  2 , Carlo Vancheri  1 , Lucia Spicuzza  1
Affiliations

Use of Remdesivir in Patients Hospitalized for COVID-19 Pneumonia: Effect on the Hypoxic and Inflammatory State

Alessandro Libra et al. Viruses. .

Abstract

Remdesivir is one of the most attractive options for patients with hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19). The aim of our study was to evaluate the effect of remdesivir on the hypoxic and inflammatory state in patients with moderate to severe COVID-19. We retrospectively enrolled 112 patients admitted for COVID-19 pneumonia, requiring low-flow oxygen, 57 treated with remdesivir plus standard of care (SoC) and 55 treated only with SoC that were similar for demographic and clinical data. We evaluated changes in hypoxemia and inflammatory markers at admission (Day 0) and after 5 days of treatment (Day 5) and the clinical course of the disease. From Day 0 to Day 5, the ratio of arterial oxygen partial pressure to fractional inspired oxygen (P/F) increased from 222 ± 62 to 274 ± 97 (p < 0.0001) in the remdesivir group and decreased from 223 ± 62 to 183 ± 76 (p < 0.05) in the SoC group. Interleukine-6 levels decreased in the remdesivir (45.9 to 17.5 pg/mL, p < 0.05) but not in the SoC group. Remdesivir reduced the need for ventilatory support and the length of hospitalization. In conclusion, compared to standard care, remdesivir rapidly improves hypoxia and inflammation, causing a better course of the disease in moderate to severe COVID-19.

Keywords: IL6; P/F ratio; SARS-CoV-2; antiviral therapy; remdesivir; respiratory failure.

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Conflict of interest statement

G.S. reports personal fees from Boehringer Ingelheim outside the submitted work; C.V. is part of the F. Hoffmann-La Roche Ltd. and Boehringer Ingelheim Scientific board. He has received consulting fees and/or speaker fees from AstraZeneca, Boehringer Ingelheim, C.F. Hoffmann-La Roche Ltd. and Menarini. A.L., G.M., L.S., E.S., A.M. and N.C. declare no conflict of interest.

Figures

Figure 1
Figure 1
Changes in P/F and IL-6 from baseline (Day 0) to Day 5 in patients treated with remdesivir or standard of care. NS: not significant.
Figure 2
Figure 2
Differences in terms of length of stay in remdesivir and standard of care patients. Stars in the figure shows extreme outlier.
Figure 3
Figure 3
Correlation between absolute change in P/F ratio and days of hospitalization in all patients.
See this image and copyright information in PMC

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