A research published Thursday in JAMA Network Open revealed that treatment with the antiviral medication remdesivir provided no clinical benefit to individuals hospitalised with COVID-19, even lengthening their stay in healthcare facilities.
Patients who received the medication, which was initially intended to treat the Ebola virus, stayed in the hospital for an average of six days, while those who did not received it were discharged after three days, according to the statistics.
However, many of the remdesivir-treated patients may have been kept in the hospital simply to complete their course of the drug, and not because of any side effects or complications related to the treatment, the researchers said.
Still, 12% of the patients given remdesivir in the study died from COVID-19, while 11% of those who served as controls and were not treated with the drug did not survive the virus.
“Examination of the timing of remdesivir treatment and hospital discharge suggested that clinicians were keeping some patients in the hospital simply to complete remdesivir courses, even though the patients may otherwise have been ready to leave the hospital,” study co-author Dr. Michel Ohl told UPI in an email.
“The implication is that routine use of remdesivir may have led to increased use of hospital beds during the COVID-19 pandemic, without improving outcomes,” said Ohl, an infectious disease specialist at the University of Iowa Hospital and Clinics in Iowa City.
Remdesivir, an antiviral drug developed during the Ebola crisis in Western Africa in 2015, has been evaluated as a possible treatment for those infected with the coronavirus in multiple clinical trials since the start of the pandemic last year.
Most recently, a World Health Organization-led research discovered that the medication did not enhance outcomes in individuals hospitalised with the infection.
Because of these and other research findings, the WHO advised against using it in COVID-19 patients in November.
The US Food and Drug Administration, on the other hand, had only a month earlier authorised remdesivir for treatment in individuals hospitalised with severe COVID-19. Former President Donald Trump, who was diagnosed with COVID-19 in October, is one of the patients in the United States who has received treatment with the medication.
In addition, treatment guidelines from the National Institutes of Health and the Infectious Disease Society of America still recommend its use in “severely ill” patients, particularly those struggling to breathe even on ventilator support.
For this study, Ohl and his colleagues reviewed the records of nearly 6,000 COVID-19 patients at 123 Veterans’ Health Administration hospitals, about 40% of whom received remdesivir.
Those given the drug received 200 milligrams as the first treatment, followed by 100 mg. daily for either five or 10 days, the researchers said.
Approximately 94 percent of the patients in the research were men, and the majority were elderly, in their late sixties.
Almost half of the patients in the trial were given the steroid dexasmethasone, which has been demonstrated to decrease virus-induced heart and lung inflammation.
As symptoms deteriorated, one in every five trial participants was admitted to the hospital critical care unit, and around 6% of those treated with remdesivir required mechanical breathing, compared to 4% in the non-remdesivir group.
“It is reasonable to use remdesivir in selected patients … but clinicians should avoid admitting people or keeping people in hospital solely to receive [the drug] if they do not meet other criteria for hospitalization,” Ohl said.
In the study, “clinicians were keeping some patients in the hospital simply to complete arbitrary five- or 10-day remdesivir courses, when they otherwise may have met criteria for discharge — so, longer length of stay was a potential unintended consequence of the way remdesivir was used in practice,” he said.