{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T02:35:34Z","timestamp":1770345334093,"version":"3.49.0"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,9]],"date-time":"2025-03-09T00:00:00Z","timestamp":1741478400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Conflicting results from randomized trials regarding the efficacy of remdesivir for COVID\u201019 have been reported. We aimed to develop a neural network (NN) to identify COVID\u201019 patients who would derive the greatest survival benefit from remdesivir. This multicenter observational study included adults hospitalized for COVID\u201019 between February 2020 and February 2021. A derivation cohort from Hospital Cl\u00ednic (Barcelona) was used to create the NN, which was split into 928\/1160 (80%) for training and 232\/1160 (20%) for internal validation. The model used three normalized input variables: Ct values from rRT\u2010PCR, lymphocyte count at diagnosis, and the duration of symptoms before testing. Effectiveness was assessed in an external validation cohort of 898 patients from Hospital M\u00fatua Terrassa and Hospital Universitari La Fe, Valencia. In the derivation cohort (median age 66 years; IQR 55\u201378), symptom duration, Ct values, and lymphocyte count showed considerable variation. Overall, 60\u2010day mortality was 165\/1160 (14.2%). In the training set, 385\/928 (41.5%) patients were identified as benefiting from remdesivir, characterized by lower Ct values, reduced lymphocyte counts, and shorter symptom duration. Mortality in this subgroup was 93\/385 (24.2%): 6\/385 (7.2%) in patients receiving remdesivir versus 87\/385 (28.8%) in those who did not (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). In the test set, 296\/898 (33%) patients were identified as high\u2010benefit, with 60\u2010day mortality rates of 8\/296 (11%) for those patients treated with remdesivir compared to 49\/296 (22%) for those not treated (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.04). In conclusion, we successfully developed and validated a NN capable of identifying patients with distinct clinical phenotypes who are at higher risk of mortality without remdesivir.\n                  <\/jats:p>","DOI":"10.1002\/jmv.70276","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T02:00:57Z","timestamp":1741744857000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["COVID\u201019 Patients Benefitting From Remdesivir for Improved Survival: A Neural Network\u2010Based Approach"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8915-0683","authenticated-orcid":false,"given":"Carolina","family":"Garcia\u2010Vidal","sequence":"first","affiliation":[{"name":"Infectious Disease Department, Hospital Clinic of Barcelona\u2010IDIBAPS University of Barcelona Barcelona Spain"},{"name":"Facultat de Medicina i Ci\u00e8ncies de la Salut Universitat de Barcelona (UB) Barcelona Spain"},{"name":"CIBERINF Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Teij\u00f3n\u2010Lumbreras","sequence":"additional","affiliation":[{"name":"Infectious Disease Department, Hospital Clinic of Barcelona\u2010IDIBAPS University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tommaso Francesco","family":"Aiello","sequence":"additional","affiliation":[{"name":"Infectious Disease Department, Hospital Clinic of Barcelona\u2010IDIBAPS University of Barcelona Barcelona Spain"},{"name":"Facultat de Medicina i Ci\u00e8ncies de la Salut Universitat de Barcelona (UB) Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Chumbita","sequence":"additional","affiliation":[{"name":"Infectious Disease Department, Hospital Clinic of Barcelona\u2010IDIBAPS University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosario","family":"Menendez","sequence":"additional","affiliation":[{"name":"Pneumology Department La Fe University and Polytechnic Hospital Valencia Spain"},{"name":"Respiratory Infections. Health Research Institute La Fe (IISLAFE) Valencia Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos III Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aina Mateu","family":"Subir\u00e0","sequence":"additional","affiliation":[{"name":"Infectious Disease Department Hospital Universitari Mutua de Terrassa Barcelona Terrassa Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Peyrony","sequence":"additional","affiliation":[{"name":"Emergency Department H\u00f4pital Saint Louis, Assistance Publique\u2010H\u00f4pitaux de Paris Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Monz\u00f3\u2010Gallo","sequence":"additional","affiliation":[{"name":"Infectious Disease Department, Hospital Clinic of Barcelona\u2010IDIBAPS University of Barcelona Barcelona Spain"},{"name":"CIBERINF Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Gallardo\u2010Pizarro","sequence":"additional","affiliation":[{"name":"Infectious Disease Department, Hospital Clinic of Barcelona\u2010IDIBAPS University of Barcelona Barcelona Spain"},{"name":"CIBERINF Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ra\u00fal","family":"M\u00e9ndez","sequence":"additional","affiliation":[{"name":"Pneumology Department La Fe University and Polytechnic Hospital Valencia Spain"},{"name":"Respiratory Infections. Health Research Institute La Fe (IISLAFE) Valencia Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Respiratorias (CIBERES). 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