Zeitschrift für Arzneimittelentwicklung
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Mortality in Patients of COVID-19 when given Remdesivir in Early Stages of the Disease as Compared to Late Stages of the Disease in Pakistani Population

Zahabia Manzoor, Haaris Inam Khan*, Saddiq ul Abidin, Fatima Maqsood, Ahsan Farooq Khan, Syed Muhammad Sikandar, Alina Fakhar, Khalid Shahzad8

Background: Various drugs have been studied in the management of COVID-19 infection and the only antiviral that has been proven efficacious is Remdesivir which is a broad spectrum antiviral agent having activity against RNA dependent viral RNA polymerase.

Objective: To compare the frequency of mortality in patients of COVID-19 when given Remdesivir in early stages of the disease as compared to the late stages of the disease.

Study design: Retrospective comparative cross sectional study. Study setting Farooq hospital Lahore, Pakistan.

Study duration: 12 Months.

Data analysis: All patients admitted from January 2020 till December 2020 above 18 years of age of either gender diagnosed COVID-19 positive by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) with moderate illness, having classical radiological lesions of COVID-19 on X-ray chest or High-Resolution Computed Tomography (HRCT) chest, respiratory rate>22/min and >50% of radiological involvement of lung with typical lesions, deranged ≥ 2 biochemical markers CRP>20 mg/l, LDH>600 U/L, D Dimers>500 ng/ml, serum ferritin<500 ng/ml were enrolled. Patients who died before completion of therapy, required invasive mechanical ventilation at the time of presentation, and those patients who also received other experimental therapies, including convalescent plasma, tocilizumab or thrombolytic were excluded from the study. Data was entered and analyzed using SPSS 22. Quantitative variables were presented as mean and standard deviation while qualitative variables were presented as frequency and percentages. The difference between means of continuous variables was assessed using t-test/Mann Whitney-U test and difference between proportions of categorical variables, using Fisher’s exact test/Chi-square test. Differences in outcomes between the study groups were considered significant if p<0.05 (two-sided).

Results: In our study a total of 111 patients were enrolled with mean age of 44.25 ± 14.3 years (18-78 years). In these patients Remdesivir was started in less than 5 days, within 5-10 days and greater than 10 days with mortality of 27.7%, 40.5% and 63% respectively.

Conclusion: Our study concludes that remdesivir treatment is more effective when started in early course of treatment as compared to when its initiation was delayed. All patients presenting with moderate to severe disease should be started with remdesivir soon after the onset of symptoms which would result in decreased mortality.