The antiviral drug remdesivir and corticosteroids have been linked to higher outcomes in COVID-19 sufferers admitted on to a hospital ward within the Netherlands, suggests a real-world study revealed at the moment in Open Discussion board Infectious Ailments.
The nationwide research, led by College of Amsterdam researchers, concerned 5,643 COVID-19 sufferers admitted to 11 hospitals throughout 4 pandemic waves, from Feb 27, 2020, to Dec 31, 2021. Sufferers acquired remdesivir, corticosteroids, the antimalarial drug hydroxychloroquine, immune-suppressing interleukin-6 (IL-6) antagonists, or mixtures thereof; intensive care unit (ICU) sufferers did not obtain remdesivir.
Over the 4 waves, general median age fell from 67 to 64 years, and in-hospital loss of life charges dropped from 21% to fifteen%. Of the 5,187 sufferers admitted on to a ward, median age was 66 years, 59% have been males, 13% have been later admitted to an ICU, and 17% died within the hospital. Median age within the 456 sufferers admitted on to an ICU was 65 years, 75% have been males, 26% died within the ICU, and 33% died throughout admission.
Amongst sufferers admitted on to a ward, remdesivir was linked to a better fee of hospital launch inside 29 days (hazard ratio [HR], 1.16), and corticosteroids have been tied to a decrease probability of in-hospital loss of life (HR, 0.81) and loss of life by 12 weeks (HR, 0.84). Hydroxychloroquine was related to an elevated threat of loss of life (HR, 1.54), and the outcomes of IL-6 antagonists have been inconclusive.
In sufferers admitted on to an ICU, hydroxychloroquine, corticosteroids, and IL-6 antagonists weren’t tied to a decrease threat of loss of life or hospital launch alive.
The authors cautioned that adjustments within the predominant circulating SARS-CoV-2 variants, affected person COVID-19 vaccination standing, and use of noninvasive air flow and high-flow nasal oxygen remedy in the course of the research doubtless influenced the research outcomes and remedy results.
“Given the continuing evolution of the SARS-CoV-2 virus with novel clinically important mutants showing at a gentle state throughout altering affected person’s traits over time, it’s important to constantly re-evaluate the real-world effectiveness of newly launched medication to deal with COVID19,” they wrote.