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Amirizadeh M, Kharazmkia A, Sharifi abdoli K, Hayati abbarik H, Azimi G. The effect of remdesivir on mortality and the outcome of patients with COVID-19 in intensive care unit: A case-control study. Health Sci Rep 2023; 6:e1676. [PMID: 37927542 PMCID: PMC10620375 DOI: 10.1002/hsr2.1676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/14/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023] Open
Affiliation(s)
- Mehran Amirizadeh
- Department of Clinical Pharmacy, School of PharmacyLorestan University of Medical SciencesKhorramabadIran
| | - Ali Kharazmkia
- Department of Clinical Pharmacy, School of PharmacyLorestan University of Medical SciencesKhorramabadIran
- Clinical Research Development Center, Shahid Rahimi HospitalLorestan University of Medical SciencesKhorramabadIran
| | - Kobra Sharifi abdoli
- Student Research Committee, School of PharmacyLorestan University of Medical SciencesKhorramabadIran
| | - Hadi Hayati abbarik
- Department of Pharmacoeconomics and Management, School of PharmacyLorestan University of Medical SciencesKhorramabadIran
| | - Ghasem Azimi
- Department of Internal Medicine, School of MedicineShahed UniversityTehranIran
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De Vito A, Poliseno M, Colpani A, Zauli B, Puci MV, Santantonio T, Meloni MC, Fois M, Fanelli C, Saderi L, Fois A, Fiore V, Sotgiu G, Babudieri S, Lo Caputo S, Madeddu G. Reduced risk of death in people with SARS-CoV-2 infection treated with remdesivir: a nested case-control study. Curr Med Res Opin 2022; 38:2029-2033. [PMID: 36170020 DOI: 10.1080/03007995.2022.2129801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Since the start of the SARS-CoV-2 pandemic, several treatment options have been proposed (e.g. steroids, heparin, antivirals and monoclonal antibodies). Remdesivir was the first antiviral approved for the treatment of COVID-19, even though controversial evidence exists concerning the efficacy. Therefore, we aimed to conduct a study to evaluate whether the use of remdesivir was associated with lower mortality in patients with COVID-19. METHODS We conducted a nested case-control study of a retrospective cohort collecting medical records of people with SARS-CoV-2 infection admitted in the infectious Disease Unit of Sassari University Hospital (S.C. Clinica di Malattie Infettive, AOU di Sassari, Italy), or in the Infectious Disease Unit of Foggia (AOU "Ospedali Riuniti" Foggia), between 1 July 2020 and 10 November 2021. The outcome considered was death; thus, we matched death (cases) to survivors (controls) by sex and age (1:1). RESULTS We included in the study 342 patients, with 171 deaths (cases) and 171 survivors (controls). Remdesivir was administered to 60 people in the control group and to 18 people in the case group (35.1% vs. 10.5%, p < .0001). In the multivariate analysis, treatment with remdesivir and heparin was associated with lower mortality (OR: 0.19 [95% CI :0.10-0.38], p <.0001; OR: 0.39 [95% CI: 0.21-0.74] p = .004, respectively). On the contrary, diabetes, oxygen therapy and CPAP/NIV were associated with higher mortality. CONCLUSION Our study showed lower mortality in people with SARS-CoV-2 infection treated with remdesivir.
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Affiliation(s)
- Andrea De Vito
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Mariacristina Poliseno
- S.C. Malattie Infettive, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Foggia, Foggia, Italy
| | - Agnese Colpani
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Beatrice Zauli
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Mariangela Valentina Puci
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Teresa Santantonio
- S.C. Malattie Infettive, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Foggia, Foggia, Italy
| | - Maria Chiara Meloni
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Marco Fois
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Chiara Fanelli
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Alessandro Fois
- Unit of Respiratory Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Vito Fiore
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Sergio Babudieri
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Sergio Lo Caputo
- S.C. Malattie Infettive, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Foggia, Foggia, Italy
| | - Giordano Madeddu
- Unit of Infectious Diseases, Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Ticinesi A, Tuttolomondo D, Nouvenne A, Parise A, Cerundolo N, Prati B, Zanichelli I, Guerra A, Gaibazzi N, Meschi T. Co-Administration of Remdesivir and Azithromycin May Protect against Intensive Care Unit Admission in COVID-19 Pneumonia Requiring Hospitalization: A Real-Life Observational Study. Antibiotics (Basel) 2022; 11:antibiotics11070941. [PMID: 35884195 PMCID: PMC9311950 DOI: 10.3390/antibiotics11070941] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/08/2022] [Accepted: 07/12/2022] [Indexed: 02/07/2023] Open
Abstract
The benefits of remdesivir treatment, with or without co-administration of antibiotics such as azithromycin, are uncertain in COVID-19 pneumonia. The aim of this retrospective single-center study was to assess the effects of remdesivir, with or without azithromycin, on hospital mortality, intensive care unit (ICU) admission, and need of non-invasive ventilation. The clinical records of the COVID-19 patients hospitalized in an Italian ward in March 2021 were analyzed, and data on comorbidities and clinical, radiological, and laboratory presentation of the disease were collected. Among 394 participants (234 M), 173 received remdesivir (43.9%), including 81 with azithromycin (20.5%). Remdesivir recipients were younger, with less comorbidities, and had better PaO2/FiO2 and clinical outcomes, including reduced mortality, but the differences were not independent of covariates. Rates of ICU transferal were 17%, 9%, and 1% in the no remdesivir, remdesivir without azithromycin, and remdesivir/azithromycin groups, respectively. In a stepwise multivariate logistic regression model, remdesivir/azithromycin co-treatment was independently associated with reduced ICU admission (vs remdesivir alone, OR 0.081, 95% CI 0.008-0.789, p = 0.031; vs no remdesivir, OR 0.060, 95% CI 0.007-0.508, p = 0.010). These data suggest that the therapeutical effect of remdesivir in COVID-19 pneumonia may be potentiated by azithromycin. The association between the two drugs should be further investigated.
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Affiliation(s)
- Andrea Ticinesi
- Department of Medicine and Surgery, University of Parma, Via Antonio Gramsci 14, 43126 Parma, Italy; (D.T.); (I.Z.); (A.G.); (T.M.)
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy; (A.N.); (A.P.); (N.C.); (B.P.)
- Correspondence:
| | - Domenico Tuttolomondo
- Department of Medicine and Surgery, University of Parma, Via Antonio Gramsci 14, 43126 Parma, Italy; (D.T.); (I.Z.); (A.G.); (T.M.)
- Department of Cardiology, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy;
| | - Antonio Nouvenne
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy; (A.N.); (A.P.); (N.C.); (B.P.)
| | - Alberto Parise
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy; (A.N.); (A.P.); (N.C.); (B.P.)
| | - Nicoletta Cerundolo
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy; (A.N.); (A.P.); (N.C.); (B.P.)
| | - Beatrice Prati
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy; (A.N.); (A.P.); (N.C.); (B.P.)
| | - Ilaria Zanichelli
- Department of Medicine and Surgery, University of Parma, Via Antonio Gramsci 14, 43126 Parma, Italy; (D.T.); (I.Z.); (A.G.); (T.M.)
| | - Angela Guerra
- Department of Medicine and Surgery, University of Parma, Via Antonio Gramsci 14, 43126 Parma, Italy; (D.T.); (I.Z.); (A.G.); (T.M.)
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy; (A.N.); (A.P.); (N.C.); (B.P.)
| | - Nicola Gaibazzi
- Department of Cardiology, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy;
| | - Tiziana Meschi
- Department of Medicine and Surgery, University of Parma, Via Antonio Gramsci 14, 43126 Parma, Italy; (D.T.); (I.Z.); (A.G.); (T.M.)
- Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126 Parma, Italy; (A.N.); (A.P.); (N.C.); (B.P.)
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Islam T, Hasan M, Rahman MS, Islam MR. Comparative evaluation of authorized drugs for treating Covid-19 patients. Health Sci Rep 2022; 5:e671. [PMID: 35734340 PMCID: PMC9194463 DOI: 10.1002/hsr2.671] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/22/2022] [Accepted: 05/08/2022] [Indexed: 12/15/2022] Open
Abstract
Background and Aims Vaccines are the first line of defense against coronavirus disease 2019 (Covid-19). However, the antiviral drugs provide a new tool to fight the Covid-19 pandemic. Here we aimed for a comparative evaluation of authorized drugs for treating Covid-19 patients. Methods We searched in PubMed and Google Scholar using keywords and terms such as Covid, SARS-CoV-2, Coronavirus disease 2019, therapeutic management, hospitalized Covid-19 patients, Covid-19 treatment. We also gathered information from reputed newspapers, web portals, and websites. We thoroughly observed, screened, and included the studies relevant to our inclusion criteria. We included only the United States Food and Drug Administration (FDA) authorized drugs for this review. Results We found that molnupiravir and paxlovid are available for oral use, and remdesivir is for only hospitalized patients. Paxlovid is a combination of nirmatrelvir and ritonavir, nirmatrelvir is a protease inhibitor (ritonavir increases the concentration of nirmatrelvir), and the other two (remdesivir and molnupiravir) are nucleoside analog prodrugs. Remdesivir and molnupiravir doses do not need to adjust in renal and hepatic impairment. However, the paxlovid dose adjustment is required for mild to moderate renal or hepatic impaired patients. Also, the drug is not allowed for Covid-19 patients with severe renal or hepatic impairment. Preliminary studies showed oral antiviral drugs significantly reduce hospitalization or death among mild to severe patients. Moreover, the US FDA has approved four monoclonal antibodies for Covid-19 treatment. Studies suggest that these drugs would reduce the risk of hospitalization or severity of symptoms. World Health Organization strongly recommended the use of corticosteroids along with other antiviral drugs for severe or critically hospitalized patients. Conclusion All authorized drugs are effective in inhibiting viral replication for most SARS-CoV-2 variants. Therefore, along with vaccines, these drugs might potentially aid in fighting the Covid-19 pandemic.
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Affiliation(s)
- Towhidul Islam
- Department of PharmacyUniversity of Asia PacificDhakaBangladesh
| | - Moynul Hasan
- Department of PharmacyJagannath UniversityDhakaBangladesh
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Di Gennaro F, Gualano G, Palmieri F. Antibiotics and Infectious Respiratory Diseases. Antibiotics (Basel) 2022; 11:antibiotics11070859. [PMID: 35884113 PMCID: PMC9312235 DOI: 10.3390/antibiotics11070859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Francesco Di Gennaro
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, 00149 Rome, Italy; (G.G.); (F.P.)
- Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70123 Bari, Italy
- Correspondence:
| | - Gina Gualano
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, 00149 Rome, Italy; (G.G.); (F.P.)
| | - Fabrizio Palmieri
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, 00149 Rome, Italy; (G.G.); (F.P.)
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