The study Impact of the introduction of remdesivir in Spain, recently published in the magazine Advances in Therapy, has suggested that remdesivir, registered by Gilead under the name ‘Veklury’, could have reduced deaths from coronavirus in the first wave of Covid-19 in Spain by about 30%, as well as up to almost 44% the number of hospitalized patients with low-flow oxygen therapy cared for in ICUs.
The work, promoted by Gilead Spain, which has had the participation of six top-level clinicians and which has been coordinated by the Weber Foundation, focuses on analyzing the impact that the administration of remdesivir would have had on patients eligible for said treatment in Spain between February 20 and May 10, 2020 and, in detail, during the peak of the highest hospital pressure due to coronavirus.
Specifically, the data show that the administration of remdesivir during the first wave would have reduced by 43.71% the number of patients hospitalized in Spanish ICUs (patients with pneumonia and on low-flow oxygen therapy) at this stage by avoiding admission of 2,587 patients in them.
Likewise, and according to the results, on April 5 there were 32,264 beds occupied by Covid-19 patients, although if the same scenario were drawn with remdesivir used according to the clinical drug protocol, the hospital stay in the ward could have been reduced to 17 53%, which translates into a release of up to 5,656 beds.
Regarding ICUs, the highest occupancy records were dated April 17, with 7,088 beds occupied. In this sense, and given that this antiviral improves the clinical status of patients with coronavirus and pneumonia who require low-flow oxygen therapy, remdesivir would have reduced the ICU stay by up to 23.98%, which is to say, a release of up to 1,700 beds.
“With this study we want to show that if we had been able to count on remdesivir for hospitalized patients – in whom its use is indicated – during the most devastating months of the pandemic, many deaths from coronavirus could have been avoided and also reduced the number of patients admitted to both the ward and the ICU, since the antiviral reduces the risk of the patient evolving to the critical care unit if it is administered early, ”said the president of the Weber Foundation, Álvaro Hidalgo.
Another of the criteria for measuring the evolution and severity of the pandemic used in Spain has been that of mortality. During the first wave, 10,189 patients and 1,524 patients died in the wards of the general hospital and in the ICU, respectively, although, according to the study, the administration of remdesivir could have prevented up to 27.51% of deaths, since it would reduce the Mortality rate in hospitalized patients with COVID-19 and pneumonia receiving low-flow oxygen therapy, as observed in post hoc analysis of the ‘ACTT-1’ study.
Admissions to ICU
Therefore, the antiviral would have prevented up to 6,972 deaths in the ward in patients with these characteristics. In addition, and given that remdesivir slows the worsening of the disease, the study has indicated that it could have reduced at least half of ICU admissions, as well as avoided 667 deaths in critical care units.
«In the first wave we had a saturation of the health system with terrible mortality figures. If the use of remdesivir in hospitalized patients had been available, the situation of collapse that we are experiencing, especially in critical care units, would have been less, with greater turnover of patients in hospitals and, most importantly, with a reduction in mortality of more than 25% ”, commented Rocío Montejano, doctor from the Internal Medina Department and Infectious Diseases Research Area of the La Paz University Hospital in Madrid.
Therefore, in Hidalgo’s opinion, these figures show that the pressure on the public system could have been better controlled, optimizing and providing a more efficient use of resources in our health system thanks to the clinical benefits of remdesivir in patients with coronavirus.
Thus, experts consider that the results, together with the experience accumulated in this pandemic year, indicate that the proper use of the antiviral in people admitted for COVID-19 contributes to the “better functioning and optimization” of the resources of the health system.
Reference clinical trial
The data of the study are based on the results obtained in the reference / pivotal clinical trial ACTT-1 promoted by the American NIAID, since through them it has been possible to extrapolate the benefits that the use of remdesivir would have had on the Spanish population in case it had been available in the first wave.
ACTT-1 associates the use of the antiviral with a lower mortality rate in patients with low-flow oxygen therapy (vs placebo), a faster hospital recovery (between 5-7 days vs placebo) and a reduction in the progression of the disease at more serious stages in patients with COVID-19, with its greatest benefit when administered in earlier stages of the disease.
Likewise, these data also confirm those obtained in other studies carried out in Spain, such as the real-life analysis of the antiviral in patients with the virus carried out by the Hospital Clínic de Barcelona, published last March. In this clinical work, remdesivir was associated with a low mortality rate in patients with coronavirus and a good safety profile, in addition to showing that the early administration of the antiviral reduces hospital stay and makes the use of mechanical ventilation less necessary.