A retrospective study conducted in Manipal Hospitals found that there was reduced mortality among COVID-19 patients who were given Remdesivir within seven days of the onset of symptoms. The study, which collected and analysed data among 372 cases and has been sent to a medical journal for publication on Tuesday, concluded that careful selection of patients for Remdesivir is essential. Early diagnosis and risk stratification lead to better outcomes, it found.
The patients in the study were moderately ill and reported symptoms of fever, body ache, cold, cough, breathlessness and low oxygen levels. The mortality rate was lower than the national average after giving this drug, said Dr Satyanarayana Mysore, HOD and Consultant- Pulmonology, Lung Transplant Physician, Manipal Hospitals
"For example, a patient with breathlessness and low oxygen levels stabilised within four days of administering Remdesivir. The length of stay in the hospital was less. Around 92 percent did not require ICU admission. If we pick up patients early and intervene, there is a reduced chance of ICU admission," Dr Mysore said.
He advised that patients with high CT scores or in need of oxygen should be given Remdesivir but those who have mild disease or are already 10 days into the illness must not be given this drug. When given too late, it has no benefit at all.
The study was conducted between June 1 and October 31, with data analyzed only later. The surge of cases during the second wave put the study, conducted by the Department of Respiratory Medicine and Pulmonology, Manipal Hospitals, on hold.
Dr Mysore said that the study was done in the backdrop of the World Health Organization study which recommended against the use of Remdesivir. In November 2020, the WHO issued a conditional recommendation against the use of Remdesivir in hospitalized patients, regardless of disease severity, stating that there is currently no evidence that it improves survival and other outcomes in these patients.
Countering this, Dr Mysore said the WHO trial was prematurely done, with no guidelines on when to use and when not to use Remdesivir. It was only concerned about using the drug.
"The WHO study received criticism from many quarters and the organisation has lacked credibility with its constantly changing statements on COVID-19. For example, they initially said there is no evidence of human-to-human transmission of the coronavirus, they said COVID-19 is not a pandemic and that asymptomatic patients do not spread the virus," he said, adding that there is a lot of misinformation on the disease on social media and also from organizations like WHO which have been inconsistent with their information.
The hospital will follow this study with more studies using data collected from patients who were admitted in the second wave.