Remdesivir Effects on COVID-19 Infection in Adult Patients

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) is a serious pandemic affecting the global world since 2019 with heavy impacts on the social, economy, and normal daily life; one of the promising antiviral treatment used frequently all over the world is the remdesivir. Aim: The aim was to study the effect of 3–5 days remdesivir treatment course, regarding its starting time on clinical status and the fate of patients with COVID-19, with monitoring of the side effects. Materials and Methods: A prospective observational study involved 90 patients with COVID-19 who received remdesivir 5 days course; all were hospitalized, diagnosed by computerised tomography (CT) chest and polymerase chain reaction (PCR) at Merjan Teaching Hospital from August 2020 to October 2020. Those 90 patients’ age ranged from 25 to 88 years. Sixty-two patients received convalescent plasma with remdesivir against 13 patients who not received it. Tocilizumab was added for 18 patients, whereas 57 were not treated with it. Clinical state (SpO2, subjective dyspnea, respiratory rate (RR), fever, and the type of O2 supplements) of the patients was assessed three times. Regarding the time of starting remdesivir treatment during the course of disease, patients were assessed in three groups: patients received remdesivir within <10 days, patients received it between 10 and 15 days, and patients received it >15 days. Mean of the duration of patients discharge was recorded. Results: It showed an extremely significant difference (P < 0.001) between the discharged and both referred to respiratory care unit (RCU) and death patients. There were significant differences (P < 0.05) in the clinical state (SpO2, subjective dyspnea, RR, fever, and the type of O2 supplements) of the patients in all three times of assessments with significant correlation (P < 0.01) between means of the clinical state (SpO2 and subjective dyspnea score) and the fate (discharge, admission to RCU, and death) of patient who received it. There were no significant differences (P > 0.05) between means of time of starting therapy and the fate of patients. At the same time, no significant differences (P > 0.05) were seen in the mean of liver function test. There were no significant differences (P > 0.05) between the fate of patients who received convalescent plasma with remdesivir, but a significant disadvantage (P < 0.001) was seen in the fate of patient who received tocilizumab. Conclusion: We can conclude that remdesivir improves the clinical state of patients with COVID-19 regardless of the time of its starting during the course of disease.