Prognostic factors of disease progression in patients with mild-to-moderate COVID-19 on early remdesivir treatment in Taiwan

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-02-14 DOI:10.1016/j.jiph.2025.102705

Yu-Chien Ho , Min-Chi Chang , Wen-Ying Lin , Chia-Ying Wu , Szu-Yu Liu , Chien Chuang , Chih-Han Juan , Chia-Jen Liu , Yi-Tsung Lin

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Abstract

Background

An early 3-day course of remdesivir treatment was recommended for high risk patients with mild-to-moderate COVID-19. We investigated the prognostic factors of disease progression and mortality in patients with mild-to-moderate COVID-19 on early remdesivir treatment in Taiwan.

Methods

Adult patients with mild-to-moderate COVID-19 treated with a 3-day course of remdesivir at Taipei Veterans General Hospital from April–July 2022 were identified. The main outcomes were 14-day disease progression (defined as increased oxygen requirement compared with the baseline condition or mortality) and 28-day mortality. Cox regression model was used to identify independent variables associated with poor outcomes.

Results

Among the 342 patients on early remdesivir treatment, 41 patients (12 %) had 14-day disease progression, and 6 patients (1.8 %) died within 28 days. Seventy-nine patients (23.1 %) did not receive COVID-19 vaccine before the diagnosis of COVID-19. Charlson Comorbidity Index (CCI) ≥ 7 was the only independent factor associated with 14-day disease progression, and nosocomial COVID-19, initial neutrophil-to-lymphocyte ratio, and C-reactive protein (CRP) > 10 mg/dL were independent factors associated with 28-day mortality. In 231 patients (67.5 %) administered at least two doses of COVID-19 vaccine, 26 patients (11.3 %) had 14-day disease progression, and 5 patients (2.2 %) died within 28 days. CCI score ≥ 7 was the only independent factor for 14-day disease progression, and CRP level > 10 mg/dL was the independent factor associated with 28-day mortality.

Conclusions

Multiple comorbidities and nosocomial COVID-19 predisposed these patients to poor outcomes. Therefore, infection prevention and control measures are important in the fight against COVID-19.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.