Routine Remdesivir Treatment Prolongs Hospital Stay, Does No
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Routine use of remdesivir in hospitalized COVID-19 patients is associated with longer hospital stays but not with improved survival, according to results from a cohort study. Remdesivir is the only antiviral drug approved by the Food and Drug Administration (FDA) for the treatment of COVID-19.

Researchers aimed to examine associations between remdesivir treatment and survival and length of hospital stay among people hospitalized with COVID-19 in routine care settings in a retrospective cohort study. For this purpose, the researchers used data from the Veterans Health Administration (VHA) to identify adult patients in 23 VHA hospitals who had a first hospitalization with laboratory-confirmed COVID-19 from May 1 to October 8, 2020.

An analytic cohort was created using propensity score matching of patients initiating remdesivir treatment to control patients who had not initiated remdesivir treatment by the same hospital day. The main outcomes were time to death within 30 days of remdesivir treatment initiation and time to hospital discharge with time to death as a competing event.

The initial cohort included 5898 patients admitted to 123 hospitals, 40.3% of whom received remdesivir treatment of whom never received remdesivir treatment. The research yielded the following findings:

• After propensity score matching, the analysis included 1172 remdesivir recipients and 1172 controls, for a final matched cohort of 2344 individuals.

• Remdesivir recipients and matched controls were similar with regard to age, sex, dexamethasone use, admission to the intensive care unit, and mechanical ventilation use.

• Standardized differences were less than 10% for all measures.

• Remdesivir treatment was not associated with 30-day mortality.

• Results were similar for people receiving vs not receiving dexamethasone at remdesivir initiation.

• Remdesivir recipients had a longer median time to hospital discharge compared with matched controls.

Routine use of remdesivir may be associated with increased use of hospital beds while not being associated with improvements in survival, concluded the authors.

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