Remdesivir Shows Reduction in Mortality in Seniors Hospitalized With COVID-19

In a large study, remdesivir (RDV) use was associated with a reduction of mortality in seniors 65 years of age and older who were hospitalized with severe COVID-19 during the period when the Omicron variant was the dominant strain of the virus. The results were shared as late-breaking research at the ongoing ESCMID Global Congress.

“Unadjusted mortality rates were 9.9% vs. 13.0% at 14-days and 13.3% vs. 16.9% at 28-days for RDV vs. non-RDV, respectively,” the investigators wrote. “RDV was associated with a significantly lower 14-day mortality (adjusted hazard ratio [95% CI]: 0.74[0.70-0.79]) and 28-day mortality (0.77[0.73-0.81]) as compared to non-RDV in the overall study cohort.

Jason Okulicz, MD, executive director, Global Medical Affairs, COVID-19 and Emerging Viruses, reiterates the severity and toll of COVID-19 within this patient population.

“The elderly populations are a very important population to [consider] for treatment,” Okulicz said. “In the US in 2023, almost two thirds of patients hospitalized for COVID-19 were over the age 65. And among those who were hospitalized, nearly 90% of deaths that occurred in the hospital due to COVID-19 were in this population.”

Study Parameters and Methods
Using the PINC AI Healthcare database, the investigators examined patients 65 years of age and older who were hospitalized with a primary diagnosis of COVID-19 between Dec 2021 to April 2023. Their analysis was broken into 3 different groups including: no supplemental oxygen charges (NSOc); low-flow oxygen (LFO); and high-flow oxygen/non-invasive ventilation (HFO/NIV) or invasive mechanical ventilation (IMV)/ECMO, as well as by age groups.

Patients were either in a cohort that included administration of remdesivir in the first 2 days of admission or those not initiating the treatment during their hospitalization, and were matched using 1:1 preferential within-hospital propensity matching (PS) with replacement. They examined the time to 14- and 28-day in-hospital mortality. Okulicz said that over 45,000 patients were given remdesivir to over 20,000, patients who were not given remdesivir.

Oxygen Requirements vs Nonrequirements
One of the important findings was that there was a consistent result across baseline supplemental oxygen requirements and different age groups.

"Even among the elderly, with different types of oxygen requirements or nonrequirements, they were shown to have reduced mortality with the use of remdesivir,” Okulicz said.

Reference
Mozaffari E, et al. Remdesivir reduces mortality in elderly patients 65+ years hospitalised for COVID-19 during Omicron. Late-breaking abstract. Presented at ESCMID. April 27-30, 2024. Barcelona, Spain.