ABSTRACT
Intro: The unavailability of specific treatment for COVID-19 prompted the empirical use of remdesivir, a viral RNA polymerase inhibitor. Since evidences present conflicting results, this study aims to determine the clinical effectiveness and adverse events of adjunctive remdesivir administration vs standard of care (non-remdesivir) in COVID-19 adult patients in a tertiary hospital in Baguio City, Philippines. Method(s): We performed a single-center, retrospective study of severe to critical COVID-19 patients admitted from September 2020 to September 2021. Stratified random sampling was employed and data collection was through chart review. Analysis was done with R Statistical Software version 4, utilizing paired T-test and McNemar test, with p-value of <0.05 considered as significant. Finding(s): A total of 318 patients were reviewed and classified into the remdesivir (n=159) and standard of care (non-remdesivir) (n=159) groups. Baseline characteristics were comparable except for co-morbidities (p<0.05). There were no noted significant differences between both groups in terms of morality (p=0.885) and reduction in chest radiograph infiltrates (p=0.182). However, the average number of days to clinical improvement (7 days vs 12 days) and recovery (16 days vs 21 days) were statistically lesser in the remdesivir group (p=0.00). Also, those who experienced diarrhea (p=0.33) and transaminitis (p=0.003) were significantly higher in those given remdesivir. Conclusion(s): There was no significant difference in terms of mortality in those given remdesivir vs standard of care alone. Nevertheless, remdesivir administration is associated with significantly faster time to clinical improvement and recovery. The drug is thought to facilitate faster lung viral load clearance and improved pulmonary function through inhibition of RNA polymerase. Though not potentially life-threatening, the drug may cause diarrhea and elevation in transaminases.Copyright © 2023
ABSTRACT
Introduction: Coronavirus Disease 2019 (COVID-19) rapidly became a global pandemic since its emergence in China in December 2019, affecting more than 4.5 million people since then. Patients with Chronic Kidney Disease on dialysis are said to be susceptible to COVID-19 infection. Data published on COVID-19 among this vulnerable group are limited, hence this study aimed to determine the clinico- demographic characteristics of patients on maintenance dialysis with COVID-19 infection and its association to clinical outcomes in a tertiary hospital in Baguio City, Philippines. Method(s): This is a cross-sectional study with a retrospective design utilizing chart review of 165 of 203 dialysis patients admitted at Baguio General Hospital and Medical Center (BGHMC) for COVID-19 infection from March 01, 2020 to December 31, 2021. The clinico- demographic characteristics were described and it determined the association of these to clinical outcomes. Both descriptive and inferential statistics were used in this study. Result(s): The mean age was 53.48 years old with male predominance. About 97% were on hemodialysis, whereas 2.5% were on peritoneal dialysis. Dialysis vintage mean was 3.19 years. Hypertension, diabetes mellitus and coronary artery disease were the most common comorbidities. Majority of them had severe COVID-19 (69%). Diabetes Mellitus as a comorbidity and COVID-19 severity status were associated with mortality, ICU admission and use of mechanical ventilation. Presence of outliers in length of hospital stay based on COVID-19 severity status and ICU admission was also observed. Conclusion(s): Diabetes Mellitus and COVID-19 severity status were associated with poor outcomes. Therefore, special attention should be given to this group emphasizing the importance of taking appropriate precautions in order to avoid getting infected with Covid-19. Achievement of good glycemic control should be emphasized. Longer data collection period could also allow future researchers investigate the impact of various treatment schemes and vaccination status on clinical outcomes. No conflict of interestCopyright © 2023