The COVID-19 pandemic has led to an explosion in clinical research that has led to the development of a variety of vaccines and treatments, though effectiveness Some of them are still controversial. Now, researchers from Japan report that the drug remdesivir, whose efficacy has been discussed, appears to make a significant difference in Japanese patients with COVID-19 who received corticosteroids in the intensive care unit.
In a study published in Sept Journal of Medical VirologyResearchers from Tokyo Medical and Dental University (TMDU) revealed that remdesivir can reduce mortality in Asian patients if it is taken shortly after the onset of COVID-19 symptoms.
Several studies have already shown that remdesivir can shorten recovery time in COVID-19 patients, although there are conflicting reports about whether the drug prevents patients from dying. In addition, previous trials have not focused on patients who need respiratory support while in the intensive care unit.
Given the inconsistent evidence regarding the survival benefit it conferred, we sought to investigate the efficacy of remdesivir in patients with COVID-19, admitted to an intensive care unit in Japan. All of these patients were being treated with corticosteroids for pneumonia, and some were receiving mechanical assistance for breathing.”
Mariko Hanfusa, first author of the study
The researchers analyzed the medical records of 168 patients with COVID-19 who were admitted to the intensive care unit of TMDU Hospital between April 2020 and November 2021. The patients were divided into groups based on whether or not they were also treated with remdesivir.
“The results showed a clear difference in patient survival based on when they received treatment with remdesivir,” says Takeo Fujiwara, senior author of the study. “Hospital mortality rates were significantly lower in ICU patients who received remdesivir and corticosteroids within 9 days of symptom onset than in patients whose remdesivir treatment was started 10 or more days after symptoms first appeared.”
A small number of patients experienced adverse events such as rash, which required them to stop taking remdesivir, while a larger number experienced acute kidney injury or liver injury but were able to continue treatment.
“Our findings suggest that, at least in most Japanese patients with severe to critical COVID-19, early treatment with remdesivir and corticosteroids is associated with reduced mortality,” says Hanafusa.
Given the survival benefit demonstrated in this study, the time since symptom onset should be considered when using remdesivir to treat critically ill patients with COVID-19. The variable efficacy of remdesivir at different time points may reflect increased viral load and lung damage over time, and could help explain why this drug’s effectiveness remains controversial.