Early Outpatient Administration of Remdesivir Shortens Recovery Time in Patients with Mild to Moderate COVID-19

Majid Hajimaghsoudi; Fatemeh Saghafi; Mahya Shorabi; Samaneh Mirzaei; Mehrnaz Moharami; Negin Daryaei; Farahnaz  Hoseinzade; Farzad Jalili; Hamid Reza  Rezaei; Yekta Rameshi; Mohsen Gholinataj Jelodar

doi:10.18502/jpc.v11i4.16017

Majid Hajimaghsoudi Department of Emergency Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Fatemeh Saghafi Department of Clinical Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Mahya Shorabi Student Research Committee, Faculty of Paramedicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Samaneh Mirzaei Department of Health in Emergencies and Disasters, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Mehrnaz Moharami Student Research Committee, Faculty of Paramedicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Negin Daryaei Student Research Committee, Faculty of Paramedicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Farahnaz Hoseinzade Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
Farzad Jalili Student Research Committee, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Hamid Reza Rezaei Student Research Committee, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Yekta Rameshi Pharmaceutical Sciences Research Center, Student Research Committee, School of Pharmacy, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Mohsen Gholinataj Jelodar Department of Internal Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

DOI: https://doi.org/10.18502/jpc.v11i4.16017

Keywords: COVID-19; SARS-CoV-2; Outpatient; Remdesivir; Complications

Abstract

Background: During COVID-19, healthcare systems in underdeveloped nations had significant challenges and were unlikely to offer the necessary care. It appears that a new, reliable healthcare model that prevents hospitalization is necessary to reduce the pressure that COVID-19 is putting on healthcare systems and patients. More particularly, as Remdesivir's use as an outpatient treatment for mild to severe SARS-CoV-2 infection has rarely been examined; we aimed to investigate in-depth comprehension of the effects of Remdesivir in these cases.

Methods: In our two-month cross-sectional study, non-hospitalized patients with mild to moderate COVID-19 who were referred to the hospital for up to 5 days of Remdesivir treatment received 200 mg of Remdesivir intravenously on day 1, followed by 100 mg of Remdesivir once daily for the subsequent 4 days. Patients were divided into groups based on the time of starting Remdesivir treatment after the appearance of symptoms: group 1 less than and equal to 7 days, and group 2 more than 7 days. Two groups were evaluated for a correlation between Remdesivir administration time and clinical symptoms on days 1 and 14 (follow-up visits).

Results: The study enrolled 273 eligible patients with a mean age of 47.5 years, of whom 112 were males and 125 were females. Results showed that patients who received Remdesivir in the first 7 days had less dyspnea (P-value<0.0001) and lung involvement (P-value<0.0001) than those who received it after 7 days at the end of the study. Patients who came later to receive Remdesivir also showed higher fatigue, AST, and ALT levels on the first day.

Conclusions: Among patients with moderate COVID-19, those who received a 5-day course of Remdesivir within 7 days of the onset of symptoms had a statistically significant difference in clinical status compared with those who received their treatments later. However, the size of this finding has uncertain clinical importance.