Early 3‑day course of remdesivir for the prevention of the progression to severe COVID‑19 in the elderly: A single‑centre, real‑life cohort study

Georgakopoulou,Vasiliki Epameinondas; Gkoufa,Aikaterini; Makrodimitri,Sotiria; Basoulis,Dimitrios; Tsakanikas,Aristeidis; Karamanakos,Georgios; Mastrogianni,Elpida; Voutsinas,Pantazis M.; Spandidos,Demetrios A.; Papageorgiou,Chrysovalantis V.; Gamaletsou,Maria N.; Sipsas,Nikolaos V.

doi:10.3892/etm.2023.12161

Early 3‑day course of remdesivir for the prevention of the progression to severe COVID‑19 in the elderly: A single‑centre, real‑life cohort study

Authors:
- Vasiliki Epameinondas Georgakopoulou
- Aikaterini Gkoufa
- Sotiria Makrodimitri
- Dimitrios Basoulis
- Aristeidis Tsakanikas
- Georgios Karamanakos
- Elpida Mastrogianni
- Pantazis M. Voutsinas
- Demetrios A. Spandidos
- Chrysovalantis V. Papageorgiou
- Maria N. Gamaletsou
- Nikolaos V. Sipsas
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Affiliations: Department of Infectious Diseases and COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, Emergency Department, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece, Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
Published online on: August 9, 2023 https://doi.org/10.3892/etm.2023.12161
Article Number: 462
Copyright: © Georgakopoulou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Remdesivir, a viral RNA polymerase inhibitor, has constituted a key component of therapeutic regimens against the pandemic caused by severe acute respiratory syndrome coronavirus‑2 (SARS‑CoV‑2). Originally approved for administration in hospitalized patients, remdesivir leads to improved outcomes in patients with moderate to severe coronavirus disease 2019 (COVID‑19). After proving to be effective in hospitalized patients, its use gained approval in early‑stage disease for symptomatic outpatients who are at a high risk of progression to severe disease. The present study is a real‑life prospective cohort study involving 143 elderly non‑hospitalized patients with SARS‑CoV‑2 (≥65 years of age) who attended the emergency department of the authors' hospital seeking care for COVID‑19 symptoms appearing within the prior 7 days. Eligible patients received intravenous remdesivir at a dose of 200 mg on the first day and 100 mg on days 2 and 3. The efficacy endpoints were set as the need for COVID‑19‑related hospitalization and all‑cause mortality in the following 28 days. A total of 143 patients participated in the study. Of these patients, 118 (82.5%) patients were vaccinated with at least two doses. All patients enrolled completed the 3‑day course, with a total of 6 out of 143 patients (4.2%) having a COVID‑19‑related hospitalization by day 28, and 5 patients (3.5%) succumbing to the disease within the study period. In the univariate Cox regression analysis, the neutrophil‑to‑lymphocyte ratio and haematological malignancy were identified as predictors of progression to severe disease, and albumin levels, the C‑reactive protein‑to‑albumin ratio (CAR) and haematological malignancy were identified as predictors of 28‑day mortality. On the whole, the findings of the present study demonstrated that among the elderly outpatients, a 3‑day course of intravenous remdesivir was associated with favourable outcomes.

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