Risk Factors for Therapeutic Intervention of Remdesivir in Mild to Moderate COVID-19-A Single-Center Retrospective Study of the COVID-19 Fourth Pandemic Period in Wakayama, Japan

• Published in: Medicina (Kaunas, Lithuania) Vol. 58; no. 1; p. 118
• Main Authors: Tamura, Shinobu, Kaki, Takahiro, Niwa, Mayako, Yamano, Yukiko, Kawai, Shintaro, Yamashita, Yusuke, Tanaka, Harumi, Saito, Yoshinobu, Kajimoto, Yoshinori, Koizumi, Yusuke, Yamaue, Hiroki, Nakao, Naoyuki, Nojiri, Takako, Hironishi, Masaya
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 13.01.2022; MDPI
• Subjects: Adenosine Monophosphate - analogs & derivatives; Alanine - analogs & derivatives; Antiviral drugs; B.1.1.7 variant; Body mass index; Chronic obstructive pulmonary disease; Coronaviruses; COVID-19; COVID-19 - drug therapy; headache; Headaches; Hospitalization; Hospitals; Humans; Intensive care; Intervention; Japan - epidemiology; Laboratories; Middle Aged; Pandemics; Pneumonia; remdesivir; Retrospective Studies; Risk Factors; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Vital signs; Japan; COVID-19; headache; hospitalization; B.1.1.7 variant; remdesivir
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina58010118

The incidence of coronavirus disease 2019 (COVID-19) has increased in Wakayama, Japan, due to the spread of the highly infectious B.1.1.7 variant. Before this event, the medical systems were almost unaffected. We aimed to assess the clinical characteristics of patients hospitalized with COVID-19 and the risk factors for therapeutic intervention of remdesivir during the fourth pandemic period in Wakayama, Japan. This single-center retrospective study enrolled 185 patients with mild to moderate COVID-19 hospitalized in our hospital without intensive care between 14 March and 31 May 2021. In this period, 125 (67.6%) of the 185 patients had the B.1.1.7 variant. Sixty-three patients (34.1%) required remdesivir treatment. Age upon admission and length of hospitalization were significantly different between remdesivir treatment and careful observation groups (mean (standard deviation); 59.6 (14.7) versus 45.3 (20.6) years; < 0.001 and median (interquartile range); 10 (9-12) versus 9 (8-10) years; < 0.001). One patient was transferred to another hospital because of disease progression. At hospital admission, age ≥60 years (odds ratio (OR) 6.90, < 0.001), a previous history of diabetes mellitus (OR 20.9, = 0.002), B.1.1.7 variant (OR 5.30; = 0.005), lower respiratory symptoms (OR 3.13, = 0.011), headache (OR 3.82, = 0.011), and fever ≥37.5 °C (OR 4.55, = 0.001) were independent risk factors to require remdesivir treatment during the admission. Conclusions: Many patients with mild to moderate COVID-19 required the therapeutic intervention of remdesivir during the fourth pandemic period in Wakayama, Japan. From the clinical data obtained at admission, these risk factors could contribute to a prediction regarding the requirement of remdesivir treatment in cases of mild to moderate COVID-19.