Treatment patterns and clinical outcomes of immunocompromised patients with COVID-19 receiving remdesivir in the inpatient setting in Japan

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2024-12-06 DOI:10.1016/j.jiac.2024.12.007

Manami Yoshida , Nao Taguchi , Yi Piao , Rikisha Gupta , Jami Peters , Mazin Abdelghany , Mel Chiang , Chen-Yu Wang , Mark Berry , Hiroshi Yotsuyanagi

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引用次数: 0

Abstract

Introduction

Remdesivir (RDV) was approved in Japan for the treatment of coronavirus disease 2019 (COVID-19) in May 2020. However, large-scale research describing the characterized use of RDV in the inpatient setting in Japan is limited. This study aimed to describe the treatment patterns and clinical outcomes of immunocompromised patients with COVID-19 treated with RDV.

Methods

We used a secondary nationwide administrative claims database of acute care hospitals in Japan. The study period was from October 19, 2020, to September 30, 2022. Patients with COVID-19 treated with RDV during hospitalization were included, and the proportion of patients with death and disease progression were calculated.

Results

The analysis included a total of 2171 immunocompromised patients treated with RDV. The mean (standard deviation) age at index date was 75.1 (13.6) years. The median time to RDV initiation from hospitalization was 1.0 days (Q1–Q3: 1.0–2.0), and the median duration of RDV treatment was 5.0 days (Q1–Q3: 3.0–5.0). At RDV initiation, 53.02% (n=1151) of patients required non-invasive positive pressure ventilation, nasal high-flow or low-flow oxygen, and 2.26% (n=49) required mechanical ventilation, extracorporeal membrane oxygenation, or intensive care unit admission. Inpatient mortality rate by day 28 was 8.98% (95% confidence interval, 7.81–10.26). By day 28, the rate of disease progression was 9.86% (n=214), and 76.83% (n=1668) were discharged.

Conclusion

This study presents practical information on outcomes and treatment patterns of RDV in immunocompromised inpatients diagnosed with COVID-19.

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日本住院患者免疫功能低下患者接受瑞德西韦的治疗模式和临床结果

Remdesivir （RDV）于2020年5月在日本被批准用于治疗2019冠状病毒病（COVID-19）。然而，大规模的研究描述了RDV在日本住院患者环境中的典型使用是有限的。本研究旨在描述免疫功能低下的COVID-19患者接受RDV治疗的治疗模式和临床结果。方法：我们使用日本急症护理医院二级全国行政索赔数据库。研究时间为2020年10月19日至2022年9月30日。纳入住院期间接受RDV治疗的COVID-19患者，计算患者死亡和疾病进展的比例。结果：该分析共纳入了2171例接受RDV治疗的免疫功能低下患者。指标日的平均（标准差）年龄为75.1（13.6）岁。从住院到RDV开始的中位时间为1.0天（Q1-Q3: 1.0-2.0）， RDV治疗的中位持续时间为5.0天（Q1-Q3: 3.0-5.0）。在RDV开始时，53.02% （n= 1151）的患者需要无创正压通气、鼻腔高流量或低流量供氧，2.26% （n=49）的患者需要机械通气、体外膜氧合或入住重症监护病房。住院患者第28天死亡率为8.98%（95%可信区间为7.81 ~ 10.26）。第28天，疾病进展率为9.86% (n=214)，出院率为76.83% （n= 1668）。结论：本研究提供了COVID-19免疫功能低下住院患者RDV的结局和治疗模式的实用信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

4.10

自引率

4.50%

发文量

303

审稿时长

47 days

期刊介绍： The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.