TY - JOUR
T1 - Treatment effect modifiers in hospitalised patients with COVID-19 receiving remdesivir and dexamethasone
AU - Leding, Cæcilie
AU - Bodilsen, Jacob
AU - Brieghel, Christian
AU - Harboe, Zitta Barrella
AU - Helleberg, Marie
AU - Holm, Claire
AU - Israelsen, Simone Bastrup
AU - Jensen, Janne
AU - Jensen, Tomas Østergaard
AU - Johansen, Isik Somuncu
AU - Johnsen, Stine
AU - Kirk, Ole
AU - Lindegaard, Birgitte
AU - Meyer, Christian Niels
AU - Mohey, Rajesh
AU - Pedersen, Lars
AU - Nielsen, Henrik
AU - Nielsen, Stig Lønberg
AU - Omland, Lars Haukali
AU - Podlekareva, Daria
AU - Ravn, Pernille
AU - Starling, Jonathan
AU - Storgaard, Merete
AU - Søborg, Christian
AU - Søgaard, Ole Schmeltz
AU - Tranborg, Torben
AU - Wiese, Lothar
AU - Worm, Signe Heide Westring
AU - Christensen, Hanne Rolighed
AU - Benfield, Thomas
PY - 2023/5
Y1 - 2023/5
N2 - BACKGROUND: The combined effectiveness of remdesivir and dexamethasone in subgroups of hospitalised patients with COVID-19 is poorly investigated.METHODS: In this nationwide retrospective cohort study, we included 3826 patients with COVID-19 hospitalised between February 2020 and April 2021. The primary outcomes were use of invasive mechanical ventilation and 30-day mortality, comparing a cohort treated with remdesivir and dexamethasone with a previous cohort treated without remdesivir and dexamethasone. We used inverse probability of treatment weighting logistic regression to assess associations with progression to invasive mechanical ventilation and 30-day mortality between the two cohorts. The analyses were conducted overall and by subgroups based on patient characteristics.RESULTS: Odds ratio for progression to invasive mechanical ventilation and 30-day mortality in individuals treated with remdesivir and dexamethasone compared to treatment with standard of care alone was 0.46 (95% confidence interval, 0.37-0.57) and 0.47 (95% confidence interval, 0.39-0.56), respectively. The reduced risk of mortality was observed in elderly patients, overweight patients and in patients requiring supplemental oxygen at admission, regardless of sex, comorbidities and symptom duration.CONCLUSIONS: Patients treated with remdesivir and dexamethasone had significantly improved outcomes compared to patients treated with standard of care alone. These effects were observed in most patient subgroups.
AB - BACKGROUND: The combined effectiveness of remdesivir and dexamethasone in subgroups of hospitalised patients with COVID-19 is poorly investigated.METHODS: In this nationwide retrospective cohort study, we included 3826 patients with COVID-19 hospitalised between February 2020 and April 2021. The primary outcomes were use of invasive mechanical ventilation and 30-day mortality, comparing a cohort treated with remdesivir and dexamethasone with a previous cohort treated without remdesivir and dexamethasone. We used inverse probability of treatment weighting logistic regression to assess associations with progression to invasive mechanical ventilation and 30-day mortality between the two cohorts. The analyses were conducted overall and by subgroups based on patient characteristics.RESULTS: Odds ratio for progression to invasive mechanical ventilation and 30-day mortality in individuals treated with remdesivir and dexamethasone compared to treatment with standard of care alone was 0.46 (95% confidence interval, 0.37-0.57) and 0.47 (95% confidence interval, 0.39-0.56), respectively. The reduced risk of mortality was observed in elderly patients, overweight patients and in patients requiring supplemental oxygen at admission, regardless of sex, comorbidities and symptom duration.CONCLUSIONS: Patients treated with remdesivir and dexamethasone had significantly improved outcomes compared to patients treated with standard of care alone. These effects were observed in most patient subgroups.
U2 - 10.1080/23744235.2023.2187081
DO - 10.1080/23744235.2023.2187081
M3 - Article
C2 - 36905638
SN - 2374-4235
VL - 55
SP - 351
EP - 360
JO - Infectious Diseases
JF - Infectious Diseases
IS - 5
ER -