Abstract
A retrospective review was undertaken to better understand the effects of Remdesivir on patient outcomes within our organisation.
Data was collected for patients treated with Remdesivir between 24/07/20-18/11/20. NHS England clinical commissioning criteria were met and COVID MDT undertaken for all cases. All patients received oxygen and dexamethasone. Patients were ranked according to 4C score; a risk stratification tool to predict mortality in patients with COVID-19 infection.
676 patients with COVID-19 were identified of whom 243(36%) received at least one dose of Remdesivir. The mean(SD) age was 60.2(16.3), 70% male, 40% Caucasian, 58% Black Asian and Minority Ethnic and 2% unknown ethnicity; mean(SD) 4C score was 9.2(3.6). 2.9% had raised ALT (>5x upper limit of normal) and 4.5% developed acute kidney injury within 10 days of Remdesivir. Median(IQR) length of stay in days for low 4C score was 10(6.25), intermediate 9(7), high 13(11.5) and very high 15(15.5) (p<0.001). Median(IQR) duration of oxygen therapy in days was significantly increased for high and very high 4C scores; 8(8) and 8(12.5) incomparison to low and intemediate scores; 4(6.25) and 5(5) (p=0.002). Median(IQR) time to first Remdesivir dose 1.5(1) days, not significantly different between 4C groups (p=0.838). Crude mortality 20%.
Our study shows Remdesivir is feasible and well-tolerated in patients with COVID-19. Moreover, we found 4C scoring useful to identify those at higher risk of morbidity/mortality in hospitalised patients. A small proportion experienced significant hepatic or renal impairment. Further data from large studies will identify those who may gain the greatest benefit from Remdesivir.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3683.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021