Remdesivir for the treatment of patients hospitalized with COVID-19 receiving supplemental oxygen: a targeted literature review and meta-analysis

Rachel Beckerman; Andrea Gori; Sushanth Jeyakumar; Jakob J. Malin; Roger Paredes; Pedro Póvoa; Nathaniel J. Smith; Armando Teixeira-Pinto

doi:10.1038/s41598-022-13680-6

Remdesivir for the treatment of patients hospitalized with COVID-19 receiving supplemental oxygen: a targeted literature review and meta-analysis

Rachel Beckerman^*, Andrea Gori, Sushanth Jeyakumar, Jakob J. Malin, Roger Paredes, Pedro Póvoa, Nathaniel J. Smith, Armando Teixeira-Pinto

^*Kontaktforfatter

KI, OUH, Forskningsenhed for Klinisk Epidemiologi (Odense)

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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Abstract

This network meta-analysis (NMA) assessed the efficacy of remdesivir in hospitalized patients with COVID-19 requiring supplemental oxygen. Randomized controlled trials of hospitalized patients with COVID-19, where patients were receiving supplemental oxygen at baseline and at least one arm received treatment with remdesivir, were identified. Outcomes included mortality, recovery, and no longer requiring supplemental oxygen. NMAs were performed for low-flow oxygen (LFO₂); high-flow oxygen (HFO₂), including NIV (non-invasive ventilation); or oxygen at any flow (AnyO₂) at early (day 14/15) and late (day 28/29) time points. Six studies were included (N = 5245 patients) in the NMA. Remdesivir lowered early and late mortality among AnyO₂ patients (risk ratio (RR) 0.52, 95% credible interval (CrI) 0.34–0.79; RR 0.81, 95%CrI 0.69–0.95) and LFO₂ patients (RR 0.21, 95%CrI 0.09–0.46; RR 0.24, 95%CrI 0.11–0.48); no improvement was observed among HFO₂ patients. Improved early and late recovery was observed among LFO₂ patients (RR 1.22, 95%CrI 1.09–1.38; RR 1.17, 95%CrI 1.09–1.28). Remdesivir also lowered the requirement for oxygen support among all patient subgroups. Among hospitalized patients with COVID-19 requiring supplemental oxygen at baseline, use of remdesivir compared to best supportive care is likely to improve the risk of mortality, recovery and need for oxygen support in AnyO₂ and LFO₂ patients.

Originalsprog	Engelsk
Artikelnummer	9622
Tidsskrift	Scientific Reports
Vol/bind	12
Antal sider	11
ISSN	2045-2322
DOI	https://doi.org/10.1038/s41598-022-13680-6
Status	Udgivet - 10. jun. 2022

Bibliografisk note

Funding Information:
AG has received research grants, advisory board fees, and travel grants from Angelini, Menarini, Gilead Sciences, Janssen, MSD, Novarti, Pfizer, ViiV, and GSK. JJM received consulting fees from Maple Health Group and Atriva Therapeutics GmbH, reimbursements for travel expenses from Gilead Sciences, ViiV Healthcare and Correvio Pharma, institutional research funding from the National Institutes of Health. PP has research grants, advisory boards fees from Technophage, MSD, Abionic and Gilead Sciences. RP has received research support (awarded to his institution) and participated in advisory boards from Gilead, ViiV Healthcare, MSD, Lilly and Theratechnologies. RB, SJ, RP, MJS and ATP have no competing interests to declare.

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10.1038/s41598-022-13680-6Licens: CC BY

Open Access VersionForlagets udgivne version, 1,92 MBLicens: CC BY

Citationsformater

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abstract = "This network meta-analysis (NMA) assessed the efficacy of remdesivir in hospitalized patients with COVID-19 requiring supplemental oxygen. Randomized controlled trials of hospitalized patients with COVID-19, where patients were receiving supplemental oxygen at baseline and at least one arm received treatment with remdesivir, were identified. Outcomes included mortality, recovery, and no longer requiring supplemental oxygen. NMAs were performed for low-flow oxygen (LFO2); high-flow oxygen (HFO2), including NIV (non-invasive ventilation); or oxygen at any flow (AnyO2) at early (day 14/15) and late (day 28/29) time points. Six studies were included (N = 5245 patients) in the NMA. Remdesivir lowered early and late mortality among AnyO2 patients (risk ratio (RR) 0.52, 95% credible interval (CrI) 0.34–0.79; RR 0.81, 95%CrI 0.69–0.95) and LFO2 patients (RR 0.21, 95%CrI 0.09–0.46; RR 0.24, 95%CrI 0.11–0.48); no improvement was observed among HFO2 patients. Improved early and late recovery was observed among LFO2 patients (RR 1.22, 95%CrI 1.09–1.38; RR 1.17, 95%CrI 1.09–1.28). Remdesivir also lowered the requirement for oxygen support among all patient subgroups. Among hospitalized patients with COVID-19 requiring supplemental oxygen at baseline, use of remdesivir compared to best supportive care is likely to improve the risk of mortality, recovery and need for oxygen support in AnyO2 and LFO2 patients.",

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T1 - Remdesivir for the treatment of patients hospitalized with COVID-19 receiving supplemental oxygen

T2 - a targeted literature review and meta-analysis

AU - Beckerman, Rachel

AU - Gori, Andrea

AU - Jeyakumar, Sushanth

AU - Malin, Jakob J.

AU - Paredes, Roger

AU - Póvoa, Pedro

AU - Smith, Nathaniel J.

AU - Teixeira-Pinto, Armando

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Y1 - 2022/6/10

N2 - This network meta-analysis (NMA) assessed the efficacy of remdesivir in hospitalized patients with COVID-19 requiring supplemental oxygen. Randomized controlled trials of hospitalized patients with COVID-19, where patients were receiving supplemental oxygen at baseline and at least one arm received treatment with remdesivir, were identified. Outcomes included mortality, recovery, and no longer requiring supplemental oxygen. NMAs were performed for low-flow oxygen (LFO2); high-flow oxygen (HFO2), including NIV (non-invasive ventilation); or oxygen at any flow (AnyO2) at early (day 14/15) and late (day 28/29) time points. Six studies were included (N = 5245 patients) in the NMA. Remdesivir lowered early and late mortality among AnyO2 patients (risk ratio (RR) 0.52, 95% credible interval (CrI) 0.34–0.79; RR 0.81, 95%CrI 0.69–0.95) and LFO2 patients (RR 0.21, 95%CrI 0.09–0.46; RR 0.24, 95%CrI 0.11–0.48); no improvement was observed among HFO2 patients. Improved early and late recovery was observed among LFO2 patients (RR 1.22, 95%CrI 1.09–1.38; RR 1.17, 95%CrI 1.09–1.28). Remdesivir also lowered the requirement for oxygen support among all patient subgroups. Among hospitalized patients with COVID-19 requiring supplemental oxygen at baseline, use of remdesivir compared to best supportive care is likely to improve the risk of mortality, recovery and need for oxygen support in AnyO2 and LFO2 patients.

AB - This network meta-analysis (NMA) assessed the efficacy of remdesivir in hospitalized patients with COVID-19 requiring supplemental oxygen. Randomized controlled trials of hospitalized patients with COVID-19, where patients were receiving supplemental oxygen at baseline and at least one arm received treatment with remdesivir, were identified. Outcomes included mortality, recovery, and no longer requiring supplemental oxygen. NMAs were performed for low-flow oxygen (LFO2); high-flow oxygen (HFO2), including NIV (non-invasive ventilation); or oxygen at any flow (AnyO2) at early (day 14/15) and late (day 28/29) time points. Six studies were included (N = 5245 patients) in the NMA. Remdesivir lowered early and late mortality among AnyO2 patients (risk ratio (RR) 0.52, 95% credible interval (CrI) 0.34–0.79; RR 0.81, 95%CrI 0.69–0.95) and LFO2 patients (RR 0.21, 95%CrI 0.09–0.46; RR 0.24, 95%CrI 0.11–0.48); no improvement was observed among HFO2 patients. Improved early and late recovery was observed among LFO2 patients (RR 1.22, 95%CrI 1.09–1.38; RR 1.17, 95%CrI 1.09–1.28). Remdesivir also lowered the requirement for oxygen support among all patient subgroups. Among hospitalized patients with COVID-19 requiring supplemental oxygen at baseline, use of remdesivir compared to best supportive care is likely to improve the risk of mortality, recovery and need for oxygen support in AnyO2 and LFO2 patients.

KW - Adenosine Monophosphate/analogs & derivatives

KW - Alanine/analogs & derivatives

KW - COVID-19/drug therapy

KW - Humans

KW - Oxygen/therapeutic use

KW - Randomized Controlled Trials as Topic

KW - Treatment Outcome

U2 - 10.1038/s41598-022-13680-6

DO - 10.1038/s41598-022-13680-6

M3 - Journal article

C2 - 35688854

AN - SCOPUS:85131903722

SN - 2045-2322

VL - 12

JO - Scientific Reports

JF - Scientific Reports

M1 - 9622

ER -

Remdesivir for the treatment of patients hospitalized with COVID-19 receiving supplemental oxygen: a targeted literature review and meta-analysis

Abstract

Bibliografisk note

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