Remdesivir Cuts COVID Hospitalization Risk for Unvaccinated, But …

Remdesivir (Veklury) reduced serious outcomes among unvaccinated high-risk COVID-19 patients when given during the early symptomatic period outside the hospital, as published results from the PINETREE trial detailed.

A 3-day course of the IV antiviral cut hospitalization for COVID-19 or death from any cause by a relative 87%, albeit based on just two cases versus 15 among placebo-treated patients (0.7% vs 5.3%, P=0.008), reported Robert Gottlieb, MD, PhD, of Baylor University Medical Center in Dallas, and colleagues.

Other healthcare visits also appeared to be prevented, with a similar reduction in the composite of overall COVID-related medically attended visits or death (four vs 21 cases, 1.6% vs 8.3%, HR 0.19, 95% CI 0.07-0.56). No deaths occurred in either treatment group.

These findings, published in the New England Journal of Medicine, mirror what had been initially announced in a late-breaking presentation at the virtual IDWeek meeting in October.

“In the campaign toward ending the COVID-19 pandemic, these data add yet another option to the armamentarium for the treatment of vulnerable patients who are at high risk for progression to severe COVID-19,” the researchers concluded.

They suggested that there is still need for such treatments in regions of the world that do not yet have vaccine access and for the immunocompromised who don’t get a good vaccine response.

And indeed, “these results equate to a difference of 47 fewer hospitalizations per 1,000 infections, a clinically significant finding in an overwhelmed health care system,” noted an accompanying editorial by Emily Heil, PharmD, and Shyam Kottilil, MD, PhD, of the University of Maryland Schools of Pharmacy and Medicine, respectively, in Baltimore.

Even for vaccinated patients, antiviral agents could provide an important weapon against new variants, Heil and Kottilil added.

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