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Clinical Outcomes of COVID-19 Treated with Remdesivir Across the Continuum of Care
  • +4
  • Christina Rivera,
  • Supavit Chesdachai,
  • Evan Draper,
  • Richard Arndt,
  • Kristin C. Mara,
  • Maria Gonzalez Suarez,
  • Raymund Razonable
Christina Rivera
Mayo Clinic

Corresponding Author:rivera.christina@mayo.edu

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Supavit Chesdachai
Mayo Clinic
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Evan Draper
Mayo Clinic
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Richard Arndt
Mayo Clinic
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Kristin C. Mara
Mayo Clinic
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Maria Gonzalez Suarez
Mayo Clinic
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Raymund Razonable
Mayo Clinic
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Abstract

Introduction: During the early phase of the coronavirus disease 2019 (COVID-19), remdesivir was only approved for hospitalized patients. Our institution developed hospital-based, outpatient infusion centers for selected hospitalized patients with COVID-19 who had clinical improvement to allow for early dismissal. The outcomes of patients who transitioned to complete remdesivir in the outpatient setting were examined. Methods: Retrospective study of all hospitalized adult patients with COVID-19 who received at least one dose of remdesivir from 11/6/2020 to 11/5/2021 at one of the Mayo Clinic hospitals. Results: Among 3,029 hospitalized patients who received treatment with remdesivir for COVID-19, the majority (89.5%) completed the recommended the five-day course. Among them, 2,169 (80%) completed treatment during hospitalization, while 542 (20.0%) patients were dismissed to complete remdesivir in outpatient infusion centers. Patients who completed the treatment in the outpatient setting had lower odds of death within 28 days (aOR 0.14, 95% CI 0.06-0.32, p<0.001). However, their rate of subsequent hospital encounters within 30 days was higher (aHR 1.88, 95% CI 1.27-2.79, p=0.002). Among patients treated with remdesivir only in the inpatient setting, the adjusted odds of death within 28 days were significantly higher among those who did not complete the 5-day course of remdesivir (aOR 2.07, 95% CI 1.45-2.95, p<0.001). Conclusions: This study describes the clinical outcomes of a strategy of transitioning remdesivir therapy from inpatient to outpatient among selected patients. Mortality was lower among patients who completed the 5-day course of remdesivir.
28 Oct 2022Submitted to Influenza and other respiratory viruses
31 Oct 2022Submission Checks Completed
31 Oct 2022Assigned to Editor
31 Oct 2022Reviewer(s) Assigned
15 Feb 2023Review(s) Completed, Editorial Evaluation Pending
16 Feb 2023Editorial Decision: Revise Major
08 Mar 20231st Revision Received
11 Mar 2023Submission Checks Completed
11 Mar 2023Assigned to Editor
11 Mar 2023Reviewer(s) Assigned
27 Mar 2023Review(s) Completed, Editorial Evaluation Pending
30 Mar 2023Editorial Decision: Revise Minor
30 Mar 20232nd Revision Received
31 Mar 2023Submission Checks Completed
31 Mar 2023Assigned to Editor
01 Apr 2023Editorial Decision: Accept