Coronavirus disease 2019 (COVID-19) remains a major public health concern, with continued
resurgences of cases and substantial risk of mortality for hospitalized patients.
Remdesivir has become standard-of-care for hospitalized COVID-19 patients. Given the
continued evolution of the disease, clinical management of COVID-19 relies on evidence
from the current endemic period.Using the PINC AI Healthcare Database, remdesivir
effectiveness was evaluated among adults hospitalized with primary diagnosis of COVID-19
between December 2021 and February 2024. Three cohorts were analyzed: adults (≥18
years), elderly (≥65 years), and those with documented COVID-19 pneumonia. Analyses
were stratified by oxygen requirements. Patients who received remdesivir were matched
to those who did not receive remdesivir using propensity score matching. Cox proportional
hazards models were used to examine in-hospital mortality.169 965 adults hospitalized
for COVID-19 were included, of whom 94 129 (55.4%) initiated remdesivir in the first
2 days of hospitalization. Remdesivir was associated with significantly lower mortality
rate compared to no remdesivir among patients with no supplemental oxygen charges
(adjusted HR [95% CI]: 14-day, 0.75 [.69-.82]; 28-day, 0.77 [.72-.83]) and those requiring
supplemental oxygen: 14-day, 0.76 [.72-.81]; 28-day, 0.79 [.74-.83]; P < .0001 for
all). Similar findings were observed for elderly patients and those hospitalized with
COVID-19 pneumonia.This evidence builds on what has been learned from randomized controlled
trials from the pandemic era to inform clinical practices. Remdesivir was associated
with significant reduction in mortality for hospitalized patients including the elderly
and those with COVID-19 pneumonia.
