Researchers at Tokyo Medical and Dental University (TMDU) find that treatment with remdesivir within 9 days of the onset of COVID-19 symptoms reduces mortality in Asian patients also taking corticosteroids
Tokyo, Japan – The COVID-19 pandemic has sparked an explosion of clinical research that has led to the development of a variety of vaccines and treatments, although the effectiveness of some remains controversial. Now, researchers in Japan report that remdesivir, a drug whose effectiveness has been debated, appears to make a big difference in Japanese COVID-19 patients who received corticosteroids in the ICU.
In a study published in the Journal of Medical Virology , researchers from Tokyo Medical and Dental University (TMDU) revealed that remdesivir can reduce mortality in Asian patients if given soon after they start showing symptoms of COVID-19.
Several studies have already shown that remdesivir can shorten recovery time in COVID-19 patients, although there are conflicting reports on whether the drug prevents patients from dying. Additionally, previous trials did not focus on patients requiring respiratory support while in the ICU.
“Given the inconsistent evidence regarding the survival benefit it confers, we sought to investigate the effectiveness of remdesivir in patients with COVID-19, who were admitted to an ICU in Japan,” says Mariko Hanafusa, first author of the study. “All of these patients were being treated with corticosteroids for pneumonia and some were receiving mechanical assistance with breathing.”
The researchers analyzed the medical records of 168 COVID-19 patients admitted to the ICU of TMDU Hospital between April 2020 and November 2021. The patients were divided into groups based on whether they were also treated with remdesivir or not.
“The results showed a clear difference in patient survival depending on when they received remdesivir treatment,” says Takeo Fujiwara, lead author of the study. “In-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 began 10 or more days after symptoms developed.” first symptoms.
Kaplan-Meier survival curves of patients without remdesivir use, remdesivir use within 9 days, and remdesivir use with an interval of more than 10 days.
A small number of patients experienced adverse events such as rash, requiring them to stop taking remdesivir, while a larger proportion experienced acute kidney injury or liver damage but were able to continue treatment.
“Our findings suggest that, at least in a largely Japanese patient population with severe to critical COVID-19, early treatment with remdesivir and corticosteroids is associated with decreased mortality,” says Hanafusa.
Given the survival benefit demonstrated in this study, time from symptom onset should be considered when using remdesivir to treat patients who are critically ill with COVID-19. The variable effectiveness of remdesivir at different time points may reflect increasing viral load and lung damage over time, and could help explain why the efficacy of this drug remains controversial.
