COVID-19死亡率和remdesivir - 在重症监护机构的回顾性队列
Elizabeth S Xavier1, Vishnu R Nair2,3, Shahanas P Shajahan3
1Pulmonology, Aster Medcity, Kochi, IND.
Cureus
|January 23, 2024
概括
在中度至重度的COVID-19ICU患者中,雷梅西维尔并没有显著降低死亡率. 然而,它对重病患者或与静脉注射类固醇结合时显示出好处,这需要进一步研究.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 雷梅西维尔 (RDV) 获得了针对COVID-19的紧急使用授权.
- 它对重症监护室 (ICU) 患者死亡率的影响尚不清楚.
研究的目的:
- 评估Remdesivir在中度至重度COVID-19ICU患者的死亡率上的有效性.
- 评估二次结果,包括机械通风,临床恶化和ICU停留.
主要方法:
- 对302名中度至重度COVID-19的ICU患者进行了回顾性分析.
- 患者接受至少五剂雷梅西维尔和接受标准护理的患者之间的比较.
- 主要结局:全因死亡率.
主要成果:
- 雷梅西维尔的使用与所有原因死亡率的总体降低无关 (OR=0.76).
- 在重病患者 (OR=0.3) 和Remdesivir与静脉注射甲基prednisolone (OR=0.2-0.3) 结合使用时,观察到死亡率显著降低.
- 没有与机械通风或临床恶化有显著的关联;长时间的ICU停留被发现.
结论:
- 雷梅西维尔可能对重病的COVID-19患者或与类固醇联合使用时有所益处.
- 需要进一步的随机对照试验来证实这种联合策略的有效性.
- 目前的研究结果表明,Remdesivir在特定的COVID-19ICU小组中可能发挥作用.
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