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Scientific article
Open access
English

Treatment effect of remdesivir on the mortality of hospitalised COVID-19 patients in Switzerland across different patient groups : a tree-based model analysis

Published inSwiss medical weekly, vol. 153, 40095
Publication date2023-08-28
First online date2023-08-28
Abstract

Aims of the study: Remdesivir has shown benefits against COVID-19. However, it remains unclear whether, to what extent, and among whom remdesivir can reduce COVID-19-related mortality. We explored whether the treatment response to remdesivir differed by patient characteristics.

Methods: We analysed data collected from a hospital surveillance study conducted in 21 referral hospitals in Switzerland between 2020 and 2022. We applied model-based recursive partitioning to group patients by the association between treatment levels and mortality. We included either treatment (levels: none, remdesivir within 7 days of symptom onset, remdesivir after 7 days, or another treatment), age and sex, or treatment only as regression variables. Candidate partitioning variables included a range of risk factors and comorbidities (and age and sex unless included in regression). We repeated the analyses using local centring to correct the results for the propensity to receive treatment.

Results: Overall (n = 21,790 patients), remdesivir within 7 days was associated with increased mortality (adjusted hazard ratios 1.28-1.54 versus no treatment). The CURB-65 score caused the most instability in the regression parameters of the model. When adjusted for age and sex, patients receiving remdesivir within 7 days of onset had higher mortality than those not treated in all identified eight patient groups. When age and sex were included as partitioning variables instead, the number of groups increased to 19-20; in five to six of those branches, mortality was lower among patients who received early remdesivir. Factors determining the groups where remdesivir was potentially beneficial included the presence of oncological comorbidities, male sex, and high age.

Conclusions: Some subgroups of patients, such as individuals with oncological comorbidities or elderly males, may benefit from remdesivir.

eng
Keywords
  • Aged
  • Male
  • Humans
  • Switzerland / epidemiology
  • COVID-19
  • COVID-19 Drug Treatment
  • Hospitals
  • Antiviral Agents / therapeutic use
Funding
Citation (ISO format)
ESTILL, Janne Anton Markus et al. Treatment effect of remdesivir on the mortality of hospitalised COVID-19 patients in Switzerland across different patient groups : a tree-based model analysis. In: Swiss medical weekly, 2023, vol. 153, p. 40095. doi: 10.57187/smw.2023.40095
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Article (Published version)
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ISSN of the journal1424-3997
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