Background

There are nearly 10,000 COVID-19 hospitalizations in the US each week (CDC, 2023). Remdesivir (RDV) is an FDA-approved antiviral indicated for COVID-19 treatment in hospitalized patients and nonhospitalized patients at high risk for progression to severe disease. Untreated, those hospitalized with COVID-19 are at risk for disease progression.

Aims and Objectives

To estimate the association of RDV and progression to intensive care unit (ICU) admission by day 7 and 14 of RDV treatment in hospitalized COVID-19 patients.

Methods

In this retrospective cohort study using Health Verity data, patients hospitalized with COVID-19 from May 2020 to August 2022 aged ?18 years who received ?1 RDV dose were matched 1:1 to those who did not receive RDV. Exact matching variables included age, oxygen requirement, and calendar time; other differences were balanced by propensity score matching. Risk of ICU admission was compared via Cox proportional hazard models.

Results

Of 15,162 total matched patients, 7,581 received RDV. Median hospital stay was 6 days and 77.8% of patients were on room air at RDV start or match date. Those treated with RDV had a lower risk of progression to ICU admission by day 7 (HR 0.83, 95% CI 0.72-0.96) and 14 (HR 0.86, 95% CI 0.75-0.99; Table 1).

Conclusions

RDV was associated with a reduced risk of progression to ICU admission, reinforcing its benefits for patients hospitalized with COVID-19.