Page 91 - JCTR-11-3

Journal of Clinical and
Translational Research Remdesivir outcomes in hospitalized COVID-19

reported in several studies. Ayodele et al. described the real- participants were real-life cohort of hospitalized patients
world treatment pattern in the USA from September 2020 due to COVID-19 with high prevalence of comorbidities.
to February 2021. They reported that dexamethasone and However, our study has limitations, including the
RDV was the most common combination therapy (14.9%) retrospective single-center study design and small
among hospitalized COVID-19 patients. Similarly, Vititoe sample size. There was lack of control group to examine
29
et al. observed that the most administered combination the clinical utility of RDV compared to the standard
therapy among hospitalized COVID-19 patients (from care or other treatment regimens. Moreover, association
January 2021 to February 2022) was steroids plus RDV studies between RDV use, demographic, and clinical
(32.8%). However, the combination of steroids, RDV, and characteristics of the patients was not conducted, which
interleukin-6 inhibitors (such as tocilizumab) was the least may affect the interpretation of our findings. All these
administered (3.8%). 30 factors would introduce bias, cause unavoidable residual
The need for oxygen therapy and mechanical ventilation confounding effects, and limit the generalizability of our
among our cohort was comparable to the literature. We findings.
observed that 45.7% of the patients required oxygen 5. Conclusion
therapy. Among them, 40.95% and 10.48% of patients
needed low-flow and high-flow nasal cannulas, respectively. As with most studies, our cohort showed that the possibility
Meanwhile, 10% of the participants needed mechanical of COVID-19 infection increases with age. Although
ventilation, and 12.4% of the patients died. In the ACTT-1 people with different comorbidities are more susceptible
study, 42.9%, 17.6%, and 24.2% of participants receiving to COVID-19 infection, people without comorbidities
RDV needed supplemental oxygen therapy, high-flow are also in danger. Moreover, the dangers and severity
oxygen, and mechanical ventilation, respectively, and 11% of the disease are not only present due to its different
of the patients died. In the ACTT-2 study, supplemental symptoms but also to its ability to make the patients more
8
and high-flow oxygen were administered to 53.3%, and vulnerable to different lung infections, which easily lead to
21.8% of hospitalized COVID-19 patients, respectively. pneumonia. RDV is a promising antiviral therapy against
Mechanical ventilation was required for 11% of the study COVID-19 infection and, in most cases, dexamethasone
population, and the mortality over 28 days was 7%. 31 and tocilizumab were combined with RDV. The overall
In contrast, Spinner et al. reported that only 1% of mortality and ICU admission rates were lower than
COVID-19 patients receiving 5- or 10-day RDV therapy previously reported. In addition, the overall length of
required high-flow oxygen, and 15% and 12% of those hospital stays was comparable to the literature.
receiving 5- and 10-day RDV therapy, respectively, needed Acknowledgment
low-flow oxygen. The authors also noted no deaths in the
5-day RDV therapy group, and 1% of the patients died in The authors would like to thank Dr. Mohamed Elneny, Dr.
the 5-day RDV therapy group. Furthermore, Ayodele Ahmed Salah, and Dr. Mahmoud Elhady from RAY-CRO,
12
et al. observed that only 6.3%, 2.7%, 1.4%, 1.5%, 0%, and Egypt, for their valuable manuscript review and medical
0.2% required ICU admission, supplemental oxygen, writing.
no-invasive mechanical ventilation, invasive mechanical
ventilation, ECMO, and vasopressor use, respectively, Funding
which is lower than our own observation. 29 Gilead Sciences Ireland UC funded the medical writing of
The mean length of hospital stay in our study (14.9 days) this manuscript.
was comparable to that in the literature, as it was 10, 13,
15, and 17 days in Ali et al., Karolyi et al., Tejada et al., Conflict of interest
and Beigel et al., respectively. 8,13,32,33 The findings regarding The authors declare that they have no competing interests.
the impact of RDV on the length of hospitalization were
contradictory. Several studies have highlighted that the Author contributions
length of hospital stay was significantly longer among Conceptualization: Basem M. Alraddadi
patients receiving RDV. 32,34 Investigation: Abdullah Alraddadi, Lama Hefni, Yazeed
The strength of our study is that it offers an overall Waleed Alfadl, Wafaa Adel Toonsi, Mohammad Al
picture of the management and outcomes of hospitalized Hroub
COVID-19 patients treated with RDV over a long period Methodology: Basem M. Alraddadi, Lama Hefni
of time (from January to December 2021), including the Writing – original draft: Abdullah Alraddadi, Yazeed
period of approval for RDV in KSA. In addition, the study Waleed Alfadl

Volume 11 Issue 3 (2025) 85 doi: 10.36922/jctr.24.00027