Treatment effect modifiers in hospitalised patients with COVID-19 receiving remdesivir and dexamethasone

Cæcilie Leding; Jacob Bodilsen; Christian Brieghel; Zitta Barrella Harboe; Marie Helleberg; Claire Holm; Simone Bastrup Israelsen; Janne Jensen; Tomas Østergaard Jensen; Isik Somuncu Johansen; Stine Johnsen; Ole Kirk; Birgitte Lindegaard; Christian Niels Meyer; Rajesh Mohey; Lars Pedersen; Henrik Nielsen; Stig Lønberg Nielsen; Lars Haukali Omland; Daria Podlekareva; Pernille Ravn; Jonathan Starling; Merete Storgaard; Christian Søborg; Ole Schmeltz Søgaard; Torben Tranborg; Lothar Wiese; Signe Heide Westring Worm; Hanne Rolighed Christensen; Thomas Benfield

doi:10.1080/23744235.2023.2187081

Treatment effect modifiers in hospitalised patients with COVID-19 receiving remdesivir and dexamethasone

Cæcilie Leding^*, Jacob Bodilsen, Christian Brieghel, Zitta Barrella Harboe, Marie Helleberg, Claire Holm, Simone Bastrup Israelsen, Janne Jensen, Tomas Østergaard Jensen, Isik Somuncu Johansen, Stine Johnsen, Ole Kirk, Birgitte Lindegaard, Christian Niels Meyer, Rajesh Mohey, Lars Pedersen, Henrik Nielsen, Stig Lønberg Nielsen, Lars Haukali Omland, Daria PodlekarevaPernille Ravn, Jonathan Starling, Merete Storgaard, Christian Søborg, Ole Schmeltz Søgaard, Torben Tranborg, Lothar Wiese, Signe Heide Westring Worm, Hanne Rolighed Christensen, Thomas Benfield

^*Corresponding author for this work

2 Citations (Scopus)

Abstract

BACKGROUND: The combined effectiveness of remdesivir and dexamethasone in subgroups of hospitalised patients with COVID-19 is poorly investigated.

METHODS: In this nationwide retrospective cohort study, we included 3826 patients with COVID-19 hospitalised between February 2020 and April 2021. The primary outcomes were use of invasive mechanical ventilation and 30-day mortality, comparing a cohort treated with remdesivir and dexamethasone with a previous cohort treated without remdesivir and dexamethasone. We used inverse probability of treatment weighting logistic regression to assess associations with progression to invasive mechanical ventilation and 30-day mortality between the two cohorts. The analyses were conducted overall and by subgroups based on patient characteristics.

RESULTS: Odds ratio for progression to invasive mechanical ventilation and 30-day mortality in individuals treated with remdesivir and dexamethasone compared to treatment with standard of care alone was 0.46 (95% confidence interval, 0.37-0.57) and 0.47 (95% confidence interval, 0.39-0.56), respectively. The reduced risk of mortality was observed in elderly patients, overweight patients and in patients requiring supplemental oxygen at admission, regardless of sex, comorbidities and symptom duration.

CONCLUSIONS: Patients treated with remdesivir and dexamethasone had significantly improved outcomes compared to patients treated with standard of care alone. These effects were observed in most patient subgroups.

Original language	English
Journal	Infectious diseases (London, England)
Volume	55
Issue number	5
Pages (from-to)	351-360
Number of pages	10
ISSN	2374-4235
DOIs	https://doi.org/10.1080/23744235.2023.2187081
Publication status	Published - May 2023

Keywords

Aged
Antiviral Agents/therapeutic use
COVID-19
COVID-19 Drug Treatment
Dexamethasone/therapeutic use
Humans
Retrospective Studies
SARS-CoV-2
dexamethasone
Clinical outcome
30-day mortality
remdesivir

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10.1080/23744235.2023.2187081Licence: CC BY-NC-ND

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Leding, C., Bodilsen, J., Brieghel, C., Harboe, Z. B., Helleberg, M., Holm, C., Israelsen, S. B., Jensen, J., Jensen, T. Ø., Johansen, I. S., Johnsen, S., Kirk, O., Lindegaard, B., Meyer, C. N., Mohey, R., Pedersen, L., Nielsen, H., Nielsen, S. L., Omland, L. H., ... Benfield, T. (2023). Treatment effect modifiers in hospitalised patients with COVID-19 receiving remdesivir and dexamethasone. Infectious diseases (London, England), 55(5), 351-360. https://doi.org/10.1080/23744235.2023.2187081

Leding, C, Bodilsen, J, Brieghel, C , Harboe, ZB , Helleberg, M , Holm, C , Israelsen, SB, Jensen, J, Jensen, TØ, Johansen, IS, Johnsen, S , Kirk, O , Lindegaard, B, Meyer, CN, Mohey, R, Pedersen, L, Nielsen, H, Nielsen, SL, Omland, LH , Podlekareva, D , Ravn, P, Starling, J, Storgaard, M, Søborg, C, Søgaard, OS, Tranborg, T, Wiese, L, Worm, SHW , Christensen, HR & Benfield, T 2023, 'Treatment effect modifiers in hospitalised patients with COVID-19 receiving remdesivir and dexamethasone', Infectious diseases (London, England), vol. 55, no. 5, pp. 351-360. https://doi.org/10.1080/23744235.2023.2187081

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title = "Treatment effect modifiers in hospitalised patients with COVID-19 receiving remdesivir and dexamethasone",

abstract = "BACKGROUND: The combined effectiveness of remdesivir and dexamethasone in subgroups of hospitalised patients with COVID-19 is poorly investigated.METHODS: In this nationwide retrospective cohort study, we included 3826 patients with COVID-19 hospitalised between February 2020 and April 2021. The primary outcomes were use of invasive mechanical ventilation and 30-day mortality, comparing a cohort treated with remdesivir and dexamethasone with a previous cohort treated without remdesivir and dexamethasone. We used inverse probability of treatment weighting logistic regression to assess associations with progression to invasive mechanical ventilation and 30-day mortality between the two cohorts. The analyses were conducted overall and by subgroups based on patient characteristics.RESULTS: Odds ratio for progression to invasive mechanical ventilation and 30-day mortality in individuals treated with remdesivir and dexamethasone compared to treatment with standard of care alone was 0.46 (95% confidence interval, 0.37-0.57) and 0.47 (95% confidence interval, 0.39-0.56), respectively. The reduced risk of mortality was observed in elderly patients, overweight patients and in patients requiring supplemental oxygen at admission, regardless of sex, comorbidities and symptom duration.CONCLUSIONS: Patients treated with remdesivir and dexamethasone had significantly improved outcomes compared to patients treated with standard of care alone. These effects were observed in most patient subgroups.",

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language = "English",

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pages = "351--360",

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T1 - Treatment effect modifiers in hospitalised patients with COVID-19 receiving remdesivir and dexamethasone

AU - Leding, Cæcilie

AU - Bodilsen, Jacob

AU - Brieghel, Christian

AU - Harboe, Zitta Barrella

AU - Helleberg, Marie

AU - Holm, Claire

AU - Israelsen, Simone Bastrup

AU - Jensen, Janne

AU - Jensen, Tomas Østergaard

AU - Johansen, Isik Somuncu

AU - Johnsen, Stine

AU - Kirk, Ole

AU - Lindegaard, Birgitte

AU - Meyer, Christian Niels

AU - Mohey, Rajesh

AU - Pedersen, Lars

AU - Nielsen, Henrik

AU - Nielsen, Stig Lønberg

AU - Omland, Lars Haukali

AU - Podlekareva, Daria

AU - Ravn, Pernille

AU - Starling, Jonathan

AU - Storgaard, Merete

AU - Søborg, Christian

AU - Søgaard, Ole Schmeltz

AU - Tranborg, Torben

AU - Wiese, Lothar

AU - Worm, Signe Heide Westring

AU - Christensen, Hanne Rolighed

AU - Benfield, Thomas

PY - 2023/5

Y1 - 2023/5

N2 - BACKGROUND: The combined effectiveness of remdesivir and dexamethasone in subgroups of hospitalised patients with COVID-19 is poorly investigated.METHODS: In this nationwide retrospective cohort study, we included 3826 patients with COVID-19 hospitalised between February 2020 and April 2021. The primary outcomes were use of invasive mechanical ventilation and 30-day mortality, comparing a cohort treated with remdesivir and dexamethasone with a previous cohort treated without remdesivir and dexamethasone. We used inverse probability of treatment weighting logistic regression to assess associations with progression to invasive mechanical ventilation and 30-day mortality between the two cohorts. The analyses were conducted overall and by subgroups based on patient characteristics.RESULTS: Odds ratio for progression to invasive mechanical ventilation and 30-day mortality in individuals treated with remdesivir and dexamethasone compared to treatment with standard of care alone was 0.46 (95% confidence interval, 0.37-0.57) and 0.47 (95% confidence interval, 0.39-0.56), respectively. The reduced risk of mortality was observed in elderly patients, overweight patients and in patients requiring supplemental oxygen at admission, regardless of sex, comorbidities and symptom duration.CONCLUSIONS: Patients treated with remdesivir and dexamethasone had significantly improved outcomes compared to patients treated with standard of care alone. These effects were observed in most patient subgroups.

AB - BACKGROUND: The combined effectiveness of remdesivir and dexamethasone in subgroups of hospitalised patients with COVID-19 is poorly investigated.METHODS: In this nationwide retrospective cohort study, we included 3826 patients with COVID-19 hospitalised between February 2020 and April 2021. The primary outcomes were use of invasive mechanical ventilation and 30-day mortality, comparing a cohort treated with remdesivir and dexamethasone with a previous cohort treated without remdesivir and dexamethasone. We used inverse probability of treatment weighting logistic regression to assess associations with progression to invasive mechanical ventilation and 30-day mortality between the two cohorts. The analyses were conducted overall and by subgroups based on patient characteristics.RESULTS: Odds ratio for progression to invasive mechanical ventilation and 30-day mortality in individuals treated with remdesivir and dexamethasone compared to treatment with standard of care alone was 0.46 (95% confidence interval, 0.37-0.57) and 0.47 (95% confidence interval, 0.39-0.56), respectively. The reduced risk of mortality was observed in elderly patients, overweight patients and in patients requiring supplemental oxygen at admission, regardless of sex, comorbidities and symptom duration.CONCLUSIONS: Patients treated with remdesivir and dexamethasone had significantly improved outcomes compared to patients treated with standard of care alone. These effects were observed in most patient subgroups.

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KW - COVID-19 Drug Treatment

KW - Dexamethasone/therapeutic use

KW - Humans

KW - Retrospective Studies

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KW - dexamethasone

KW - Clinical outcome

KW - 30-day mortality

KW - remdesivir

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U2 - 10.1080/23744235.2023.2187081

DO - 10.1080/23744235.2023.2187081

M3 - Journal article

C2 - 36905638

SN - 2374-4235

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SP - 351

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JO - Infectious diseases (London, England)

JF - Infectious diseases (London, England)

IS - 5

ER -

Treatment effect modifiers in hospitalised patients with COVID-19 receiving remdesivir and dexamethasone

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