Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan

Shinya Tsuzuki, Kayoko Hayakawa, Yukari Uemura, Tomohiro Shinozaki, Nobuaki Matsunaga, Mari Terada, Setsuko Suzuki, Yusuke Asai, Koji Kitajima, Sho Saito, Gen Yamada, Taro Shibata, Masashi Kondo, Kazuo Izumi, Masayuki Hojo, Tetsuya Mizoue, Kazuhisa Yokota, Fukumi Nakamura-Uchiyama, Fumitake Saito, Wataru SugiuraNorio Ohmagari

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Objectives: To evaluate the effectiveness of remdesivir in the early stage of nonsevere COVID-19. Although several randomized controlled trials have compared the effectiveness of remdesivir with that of a placebo, there is limited evidence regarding its effect in the early stage of nonsevere COVID-19 cases. Methods: We evaluated the effectiveness of remdesivir in the early stage of nonsevere COVID-19 using the COVID-19 Registry Japan, a nationwide registry of hospitalized patients with COVID-19 in Japan. Two regimens (“start remdesivir” therapy within 4 days from admission versus no remdesivir during hospitalization) among patients without the need for supplementary oxygen therapy were compared by a 3-step processing (cloning, censoring, and weighting) method. The primary outcome was a supplementary oxygen requirement during hospitalization. Secondary outcomes were 30-day in-hospital mortality and the risk of invasive mechanical ventilation or extracorporeal membrane oxygenation (IMV/ECMO). The data of 12,487 cases met our inclusion criteria. The “start remdesivir” regimen showed a lower risk of supplementary oxygen requirement (hazard ratio [HR]: 0.850, 95% confidence interval [CI]: 0.798–0.906, p value < 0.001). Both 30-day in-hospital mortality and risk of IMV/ECMO introduction were not significantly different between the 2 regimens (HRs: 1.04 and 0.983, 95% CI: 0.980–1.09 and 0.906–1.07, p values: 0.210 and 0.678, respectively). Conclusions: Remdesivir might reduce the risk of oxygen requirement during hospitalization in the early stage of COVID-19; however, it had no positive effect on the clinical outcome and reduction in IMV/ECMO requirement.

Original languageEnglish
Pages (from-to)119-125
Number of pages7
JournalInternational Journal of Infectious Diseases
Volume118
DOIs
Publication statusPublished - 05-2022

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Fingerprint

Dive into the research topics of 'Effectiveness of remdesivir in hospitalized nonsevere patients with COVID-19 in Japan: A large observational study using the COVID-19 Registry Japan'. Together they form a unique fingerprint.

Cite this