Prognostic comparison of COVID-19 outpatients and inpatients treated with Remdesivr: A retrospective cohort study

• Published in: PloS one Vol. 17; no. 11; p. e0277413
• Main Authors: Zamani, Shokoofeh, Alizadeh, Mohammad, Shahrestanaki, Ehsan, Mohammadpoor Nami, Sahar, Qorbani, Mostafa, Aalikhani, Maryam, Hassani Gelsefid, Saeed, Mohammadian Khonsari, Nami
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 10-11-2022
• Subjects: Biology and Life Sciences; Cohort analysis; Confidence intervals; Coronaviruses; Cough; COVID-19; Fever; Health services; Hospitalization; Intravenous administration; Medical prognosis; Medicine and Health Sciences; Mortality; Oxygen; Oxygen content; Oxygen saturation; Pain; Patients; Physical Sciences; Pulse oximetry; Regression analysis; Risk analysis; Signs and symptoms; Statistical analysis; Surges; Viral diseases; Iran
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0277413

Since the late COVID-19, many countries have faced various surges and peaks within the number of infected. Iran was one of the countries that faced many surges and peaks within these years and faced many inadequacies and shortages of resources and hospital beds. Hence the healthcare system started using in-hospital medication such as Remdesivir in outpatients to reduce the load of patients admitted to the hospital. This study aimed to evaluate and compare the reported signs, symptoms, and outcomes of COVID-infected hospitalized and out-patients receiving Remdesivir. In this retrospective cohort study, 214 patients (121 outpatient and 93 hospitalized) with moderate levels of Covid infection between October 2021 and February 2022 were studied. Both groups were treated with 200mg of Remdesivir, followed by 100 mg daily intravenous injections for five days; signs and symptoms, such as pain, shortness of breath, cough, fever and etc., of patients at the initiation and the end of treatment were recorded. Moreover, the patients' blood oxygen saturation was assessed two to three times a day, and the mean of the recorded measures was considered as the daily oxygen saturation. The outpatient group had to visit the hospital daily for treatment and assessment. At the treatment's end, mortality rates, disease signs, and symptoms alleviations were compared between the groups. The outpatient and hospitalized group's mean age was 40.30 ± 12.25 and 37.70 ± 12.00 years, and 51.2% and 55.9% were males, respectively. There was no statistical difference between baseline and clinical characteristics in the outpatients and hospitalized groups. After adjusting for oxygen saturation at baseline and gender in the multivariable Cox regression analysis, the risk of death did not statistically differ between the hospitalized and outpatient group (hazard ratio: 0.99, 95% confidence interval: 0.39-2.50)) at the end of the study. Based on the results of this study, the outcome, signs, and symptoms of inpatient and outpatient Remdesivir treatment groups did not differ significantly. Hence in COVID-19 surges where we have limitations in admitting patients, outpatient Remdesivir treatment for those without any underlying diseases can be a proper management method.