Effectiveness of remdesivir in patients with COVID-19 under mechanical ventilation in an Italian ICU
Pasquini et al.
, Effectiveness of remdesivir in patients with COVID-19 under mechanical ventilation in an Italian ICU
, Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkaa321
Retrospective 51 ICU patients under mechanical ventilation, 33 treated with HCQ, showing unadjusted lower mortality with treatment.
Although the 16% lower mortality is not statistically significant, it is consistent with the significant 22% lower mortality [18‑27%]
from meta analysis of the 232 mortality results to date
This study is excluded in the after exclusion results of meta
unadjusted results with no group details.
risk of death, 16.4% lower, RR 0.84, p = 0.34, treatment 23 of 33 (69.7%), control 15 of 18 (83.3%), NNT 7.3.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Pasquini et al., 23 Aug 2020, retrospective, Italy, peer-reviewed, 9 authors, average treatment delay 10.0 days.
Abstract: J Antimicrob Chemother 2020; 75: 3359–3365
doi:10.1093/jac/dkaa321 Advance Access publication 23 August 2020
Effectiveness of remdesivir in patients with COVID-19 under
mechanical ventilation in an Italian ICU
Zeno Pasquini1,2, Roberto Montalti3, Chiara Temperoni1, Benedetta Canovari1, Mauro Mancini4,
Michele Tempesta5, Daniela Pimpini5, Nicoletta Zallocco4 and Francesco Barchiesi1,2*
*Corresponding author. E-mail: firstname.lastname@example.org
Received 20 May 2020; accepted 24 June 2020
Background: Remdesivir is a prodrug with in vitro activity against severe acute respiratory syndrome
coronavirus-2 (SARS-CoV-2). Its clinical efficacy in patients with COVID-19 under mechanical ventilation remains
to be evaluated.
Methods: This study includes patients under mechanical ventilation with confirmed SARS-CoV-2 infection
admitted to the ICU of Pesaro hospital between 29 February and 20 March 2020. During this period, remdesivir
was provided on a compassionate use basis. Clinical characteristics and outcome of patients treated with remdesivir were collected retrospectively and compared with those of patients hospitalized in the same time period.
Results: A total of 51 patients were considered, of which 25 were treated with remdesivir. The median (IQR) age
was 67 (59–75.5) years, 92% were men and symptom onset was 10 (8–12) days before admission to ICU. At
baseline, there was no significant difference in demographic characteristics, comorbidities and laboratory values
between patients treated and not treated with remdesivir. Median follow-up was 52 (46–57) days. Kaplan–Meier
curves showed significantly lower mortality among patients who had been treated with remdesivir (56% versus
92%, P < 0.001). Cox regression analysis showed that the Charlson Comorbidity Index was the only factor that
had a significant association with higher mortality (OR 1.184; 95% CI 1.027–1.365; P = 0.020), while the use of
remdesivir was associated with better survival (OR 3.506; 95% CI 1.768–6.954; P < 0.001).
Conclusions: In this study the mortality rate of patients with COVID-19 under mechanical ventilation is confirmed to be high. The use of remdesivir was associated with a significant beneficial effect on survival.
is less effective
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