Reducing Long COVID Risks

Post-COVID conditions (PCC), or long COVID, represent a persistent, multisystemic syndrome that manifests following a COVID-19 infection. The potential of antiviral drug remdesivir (RDV) to mitigate the risk and severity of PCC, especially considering the variable effects of age, is critical. Age has been a significant predictor of outcomes in patients hospitalized with COVID-19. RDV treatment correlates with a reduced risk of developing PCC in both younger and older age groups hospitalized due to COVID-19.

Among the 3,661,303 individuals hospitalized for any reason during the study period, 52,006 met the inclusion criteria for acute COVID-19, with 64.6% being younger than 65. RDV administration was reported in 36.1% of the under-65 group and 27.2% of those 65 and older. Neuropsychiatric issues emerged as the most prevalent PCC-related symptom/diagnosis, with incidence rates per 100 person-years of 58.0 for those under 65 and 52.4 for the 65 and older group.

Jason Okulicz, MD, the executive director of Global Medical Affairs in COVID-19 and Emerging Viruses, offers insights into this study at the Conference on Retroviruses and Opportunistic Infections (CROI).

The analysis leveraged the HealthVerity database, encompassing hospital chargemaster data connected to closed claims for more than 25 million U.S. patients. The study focused on patients aged 12 and above hospitalized for COVID-19 for at least two days between May 1, 2020, and September 30, 2021.

The research utilized Cox proportional hazards models with inverse probability of treatment weighting to evaluate hazard ratios (HR) for 16 PCC-related symptoms or diagnoses. These models compared patients who received RDV with those who did not. Findings indicated a significant association between RDV treatment and a lowered risk of any PCC, with HRs of 0.90 (95% CI: 0.86–0.93) for individuals under 65 and 0.90 (95% CI: 0.86–0.95) for those aged 65 and older. RDV treatment was also associated with a decreased risk for specific symptoms/diagnoses in both age categories.

The study's methodological approach allowed for the inclusion of data from patients who lacked at least 90 days of follow-up, with their information contributing person-time until the censoring date. This comprehensive analysis aimed to capture the nuanced impact of RDV on the development of PCC across different age groups, underlining the potential benefits of RDV treatment in mitigating post-COVID complications.

A substantial number of patients did not receive RDV, indicating a missed opportunity for potentially enhancing acute COVID-19 treatment and reducing long-term sequelae. The findings underscore the necessity for greater incorporation of RDV in COVID-19 treatment protocols to alleviate the impact of PCC.

Reference

Okulicz J, Berry M, Kong A, Paredes et. al. Effect of Remdesivir on Post-COVID Conditions Among Individuals Hospitalized With COVID-19 by Age. Poster #657 presented at CROI 2024. March 3-6, 2023. Denver, CO.