Treatment of patients hospitalized for COVID-19 with remdesivir is associated with lower likelihood of 30-day readmission: a retrospective observational study
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: This observational study investigated the association between remdesivir treatment during hospitalization for COVID-19 and 30-day COVID-19-related and all-cause readmission across different variants time periods. Patients & methods: Hospitalization records for adult patients discharged from a COVID-19 hospitalization between 1 May 2020 to 30 April 2022 were extracted from the US PINC AI Healthcare Database. Likelihood of 30-day readmission was compared among remdesivir-treated and nonremdesivir-treated patients using multivariable logistic regression models adjusted for age, corticosteroid treatment, Charlson comorbidity index and intensive care unit stay during the COVID-19 hospitalization. Analyses were stratified by maximum supplemental oxygen requirement and variant time period (pre-Delta, Delta and Omicron). Results: Of the 440,601 patients discharged alive after a COVID-19 hospitalization, 248,785 (56.5%) patients received remdesivir. Overall, remdesivir patients had a 30-day COVID-19-related readmission rate of 3.0% and all-cause readmission rate of 6.3% compared with 5.4% and 9.1%, respectively, for patients who did not receive remdesivir during their COVID-19 hospitalization. After adjusting for demographics and clinical characteristics, remdesivir treatment was associated with significantly lower odds of 30-day COVID-19-related readmission (odds ratio 0.60 [95% confidence interval: 0.58–0.62]), and all-cause readmission (0.73 [0.72–0.75]). Significantly lower odds of 30-day readmission in remdesivir-treated patients was observed across all variant time periods. Conclusion: Treating patients hospitalized for COVID-19 with remdesivir is associated with a statistically significant reduction in 30-day COVID-19-related and all-cause readmission across variant time periods. These findings indicate that the clinical benefit of remdesivir may extend beyond the COVID-19 hospitalization.
Tweetable abstract
Findings from a new study of routine clinical practice, throughout the COVID-19 pandemic, including over 400,000 patients from over 800 US hospitals indicates that the benefits of treating patients hospitalized for COVID-19 with remdesivir may extend beyond the hospitalization as it is associated with a 40% reduction in COVID-19 readmissions compared with not initiating remdesivir.
Plain language summary
What is this article about?
Decreasing stress on healthcare workers and the healthcare system remains an important priority as we recover from the considerable disruption caused by the pandemic. As people continue to be hospitalized for COVID-19, it is important that patients are managed appropriately with evidence-based therapies and prevent subsequent readmissions to minimize additional strain on both the healthcare system and patients. Remdesivir is a safe and effective antiviral for treatment of COVID-19 infection and has been shown to improve time to patient recovery and reduce the number of deaths. This large observational study of routine clinical practice of hospitals across the US evaluated the association between remdesivir use during COVID-19 hospitalization and likelihood of readmission.
What were the results?
The study showed that after adjusting for key patient and hospitalization characteristics, patients treated with remdesivir were 40% less likely to be readmitted to hospital within 30-days for COVID-19 and 27% less likely to be readmitted for any reason compared with patients who did not receive remdesivir. These findings were consistent across different periods of the pandemic in which different variants of concern were in circulation.
What do the results mean?
Remdesivir is recommended by clinical guidelines for the treatment of COVID-19 based on evidence from randomized controlled trials. This observational study complements the existing evidence by showing that it is also associated with a 40% reduction in the likelihood of readmissions due to COVID-19. Treating patients hospitalized for COVID-19 with remdesivir improves clinical outcomes and at the same time, may reduce the burden on healthcare systems beyond the initial COVID-19 hospitalization, potentially saving bed days for acute patients in need and reducing inconvenience to patients due to avoidable readmissions.
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© 2024 The Authors. This work is licensed under the Attribution-NonCommercial-NoDerivatives 4.0 Unported License
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Received: 7 August 2023
Accepted: 14 February 2024
Published online: 29 February 2024
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Treatment of patients hospitalized for COVID-19 with remdesivir is associated with lower likelihood of 30-day readmission: a retrospective observational study. (2024) Journal of Comparative Effectiveness Research. DOI: 10.57264/cer-2023-0131
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Citing Literature
- Veronika Müller, Martin Kolditz, Valentina Shvachko, Thomas Oppelt, Chen‐Yu Wang, Amos Lichtman, Mark Berry, Effectiveness of Remdesivir on All‐Cause In‐Hospital Mortality in Patients With Chronic Respiratory Comorbidities Who Are Hospitalized With COVID‐19 in the United States, Journal of Medical Virology, 10.1002/jmv.70926, 98, 4, (2026).
- Daniel R Kuritzkes, Remdesivir for Patients Hospitalized With COVID-19: Evidence of Effectiveness From Cohort Studies in the Omicron Era, Clinical Infectious Diseases, 10.1093/cid/ciae515, 79, Supplement_4, (S127-S130), (2024).
- Essy Mozaffari, Aastha Chandak, Robert L Gottlieb, Andre C Kalil, Heng Jiang, Thomas Oppelt, Mark Berry, Chidinma Chima-Melton, Alpesh N Amin, Remdesivir Effectiveness in Reducing the Risk of 30-Day Readmission in Vulnerable Patients Hospitalized for COVID-19: A Retrospective US Cohort Study Using Propensity Scores, Clinical Infectious Diseases, 10.1093/cid/ciae511, 79, Supplement_4, (S167-S177), (2024).
- Somayeh Mokhtari, Zahra Ayazi, Shahriar Salehi Tali, Sadegh Eskandari, Sahar Mokhtari, Examining the health status of patients with COVID-19 hospitalized in Hajar(S) Shahrekord Medical Education Center after discharge, Journal of Multidisciplinary Care, 10.34172/jmdc.1281, 13, 1, (37-43), (2024).