Prognostic factors of disease progression in patients with mild-to-moderate COVID-19 on early remdesivir treatment in...

An early 3-day course of remdesivir treatment was recommended for high risk patients with mild-to-moderate COVID-19. We investigated the prognostic factors of disease progression and mortality in patients with mild-to-moderate COVID-19 on early remdesivir treatment in Taiwan.

Adult patients with mild-to-moderate COVID-19 treated with a 3-day course of remdesivir at Taipei Veterans General Hospital from April-July 2022 were identified. The main outcomes were 14-day disease progression (defined as increased oxygen requirement compared with the baseline condition or mortality) and 28-day mortality. Cox regression model was used to identify independent variables associated with poor outcomes.

Among the 342 patients on early remdesivir treatment, 41 patients (12 %) had 14-day disease progression, and 6 patients (1.8 %) died within 28 days. Seventy-nine patients (23.1 %) did not receive COVID-19 vaccine before the diagnosis of COVID-19. Charlson Comorbidity Index (CCI) ≥ 7 was the only independent factor associated with 14-day disease progression, and nosocomial COVID-19, initial neutrophil-to-lymphocyte ratio, and C-reactive protein (CRP) > 10 mg/dL were independent factors associated with 28-day mortality. In 231 patients (67.5 %) administered at least two doses of COVID-19 vaccine, 26 patients (11.3 %) had 14-day disease progression, and 5 patients (2.2 %) died within 28 days. CCI score ≥ 7 was the only independent factor for 14-day disease progression, and CRP level > 10 mg/dL was the independent factor associated with 28-day mortality.

Multiple comorbidities and nosocomial COVID-19 predisposed these patients to poor outcomes. Therefore, infection prevention and control measures are important in the fight against COVID-19.