{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T20:22:08Z","timestamp":1768681328573,"version":"3.49.0"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T00:00:00Z","timestamp":1651104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"arlos III Institute of Health with the European Regional Development Fund","award":["JR19\/00044"],"award-info":[{"award-number":["JR19\/00044"]}]},{"name":"Spanish AIDS Research Network","award":["RD16\/0025\/ 0044"],"award-info":[{"award-number":["RD16\/0025\/ 0044"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>There is currently much uncertainty regarding the most optimal treatment for COVID-19. This study analyze the change in the clinical condition of patients hospitalized for severe COVID-19 pneumonia and treated with remdesivir in a real-life setting, based on the WHO Ordinal Scale. Clinical complications, treatment safety, and impact of other associated drugs were also analyzed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted an observational, retrospective study including patients treated with remdesivir. The need for admission to the ICU, the length of ICU and hospital stay, and the need for ventilatory support were analyzed. The laboratory parameters, drugs administered concomitantly, and difference in the length of hospital stay according to the concomitant treatment received were also evaluated. A univariate and multivariate Cox regression analysis was performed to analyze associated factors.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 92 patients were included. The mean length of hospital stay was 15 days, and 90% of the patients had been discharged from the hospital 28 days after starting treatment with remdesivir. The likelihood of hospital discharge among patients not presenting with hypertension as a comorbidity was significantly higher than that of those with this condition (HR = 3.19, P = 0.008). Nineteen patients had to be admitted to the ICU (mean of 18 days). Approximately 11% required invasive mechanical ventilation (mean of 22 days). Almost 37% of the patients received high-flow oxygen therapy and 14% non-invasive mechanical ventilation. Four deaths were recorded within the first week. Main adverse events were increases in transaminase and creatinine levels. Nosocomial infections were more frequent when remdesivir was combined with immunosuppressive drugs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Patients with severe COVID-19 pneumonia and treated with remdesivir require relatively prolonged hospital stays, many with a need for ventilatory support and, in a considerable proportion of cases, admission to the ICU. However, the observed survival rate is high, and the drug is well tolerated.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0267283","type":"journal-article","created":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T18:08:09Z","timestamp":1651169289000},"page":"e0267283","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical course of patients with severe COVID-19 pneumonia treated with remdesivir: A real-life study"],"prefix":"10.1371","volume":"17","author":[{"given":"Diana","family":"Tejada","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3772-0442","authenticated-orcid":true,"given":"Regina","family":"Juanbeltz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Rivero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ram\u00f3n","family":"San Miguel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferr\u00e1n","family":"Capdevila","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Jos\u00e9","family":"Beloqui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maite","family":"Sarobe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,4,28]]},"reference":[{"issue":"8","key":"pone.0267283.ref001","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1001\/jama.2020.12839","article-title":"Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review","volume":"324","author":"WJ Wiersinga","year":"2020","journal-title":"JAMA"},{"issue":"3","key":"pone.0267283.ref002","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/s41422-020-0282-0","article-title":"Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro","volume":"30","author":"M Wang","year":"2020","journal-title":"Cell Res"},{"issue":"7824","key":"pone.0267283.ref003","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1038\/s41586-020-2423-5","article-title":"Clinical benefit of remdesivir in rhesus macaques infected with SARS-CoV-2","volume":"585","author":"BN Williamson","year":"2020","journal-title":"Nature"},{"issue":"1","key":"pone.0267283.ref004","doi-asserted-by":"crossref","first-page":"00162","DOI":"10.1128\/CMR.00162-20","article-title":"Remdesivir against COVID-19 and Other Viral Diseases","volume":"34","author":"JJ Malin","year":"2020","journal-title":"Clin Microbiol Rev"},{"key":"pone.0267283.ref005","unstructured":"Ministerio de Sanidad. Protocolo farmacocl\u00ednico del uso de RDV. SNS. 2020 Sep 8. [cited 01 March 2022]. In: AEMPS website [Internet]. Available from: https:\/\/www.mscbs.gob.es\/profesionales\/farmacia\/valtermed\/docs\/20200908_Protocolo_farmacoclinico_remdesivir2.pdf"},{"issue":"19","key":"pone.0267283.ref006","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1056\/NEJMoa2015301","article-title":"Remdesivir for 5 or 10 Days in Patients with Severe Covid-19","volume":"383","author":"JD Goldman","year":"2020","journal-title":"N Engl J Med"},{"issue":"19","key":"pone.0267283.ref007","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1056\/NEJMoa2007764","article-title":"Remdesivir for the Treatment of Covid-19\u2014Final Report","volume":"383","author":"JH Beigel","year":"2020","journal-title":"N Engl J Med"},{"issue":"10236","key":"pone.0267283.ref008","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1016\/S0140-6736(20)31022-9","article-title":"Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial","volume":"395","author":"Y Wang","year":"2020","journal-title":"The Lancet"},{"issue":"11","key":"pone.0267283.ref009","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1001\/jama.2020.16349","article-title":"Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients with Moderate COVID-19: A Randomized Clinical Trial","volume":"324","author":"CD Spinner","year":"2020","journal-title":"JAMA"},{"key":"pone.0267283.ref010","first-page":"1","volume":"223","author":"IDEP Terap","year":"2015","journal-title":"Informe de Posicionamiento"},{"key":"pone.0267283.ref011","unstructured":"Cancer Therapy Evaluation Program (CTEP). Common Terminology Criteria for Adverse Events (CTCAE).v.5.0 [5x7]. Cancer Therapy Evaluation Program (CTEP) [Internet]. 2017;155. Available from: https:\/\/ctep.cancer.gov\/protocolDevelopment\/electronic_applications\/ctc.htm#ctc_50"},{"key":"pone.0267283.ref012","doi-asserted-by":"crossref","first-page":"104899","DOI":"10.1016\/j.phrs.2020.104899","article-title":"Compassionate remdesivir treatment of severe Covid-19 pneumonia in intensive care unit (ICU) and Non-ICU patients: Clinical outcome and differences in post-treatment hospitalisation status","volume":"158","author":"S Antinori","year":"2020","journal-title":"Pharmacol Res"},{"key":"pone.0267283.ref013","doi-asserted-by":"crossref","first-page":"100041","DOI":"10.1016\/j.lanepe.2021.100041","article-title":"Trends in mortality of hospitalised COVID-19 patients: A single centre observational cohort study from Spain","volume":"3","author":"C Garcia-Vidal","year":"2021","journal-title":"Lancet Reg Health Eur"},{"key":"pone.0267283.ref014","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.ijid.2021.01.065","article-title":"Remdesivir and systemic corticosteroids for the treatment of COVID-19: A Bayesian re-analysis","volume":"104","author":"TC Lee","year":"2021","journal-title":"Int J Infect Dis"},{"issue":"6","key":"pone.0267283.ref015","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1056\/NEJMoa2023184","article-title":"Repurposed antiviral drugs for COVID-19 \u2013interim WHO SOLIDARITY trial results","volume":"384","author":"H Pan","year":"2021","journal-title":"N Engl J Med"},{"issue":"11","key":"pone.0267283.ref016","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1016\/j.cmi.2020.07.024","article-title":"Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain","volume":"26","author":"J Berenguer","year":"2020","journal-title":"Clin Microbiol Infect"},{"issue":"12","key":"pone.0267283.ref017","doi-asserted-by":"crossref","first-page":"2309","DOI":"10.1007\/s10096-020-03927-3","article-title":"Epidemiological and clinical course of 483 patients with COVID-19 in Wuhan, China: a single-center, retrospective study from the mobile cabin hospital","volume":"39","author":"B Wang","year":"2020","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"10","key":"pone.0267283.ref018","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.medcli.2020.06.019","article-title":"Reacciones adversas a f\u00e1rmacos utilizados en el tratamiento espec\u00edfico de la infecci\u00f3n por SARS-CoV-2","volume":"155","author":"V Herrera-Lasso Reg\u00e1s","year":"2020","journal-title":"Med Clin (Barc)"},{"key":"pone.0267283.ref019","doi-asserted-by":"crossref","first-page":"625176","DOI":"10.3389\/fmed.2020.625176","article-title":"Short-Term Variations in Neutrophil-to-Lymphocyte and Urea-to-Creatinine Ratios Anticipate Intensive Care Unit Admission of COVID-19 Patients in the Emergency Department","volume":"7","author":"AG Solimando","year":"2021","journal-title":"Front Med (Lausanne)"},{"issue":"1","key":"pone.0267283.ref020","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1186\/s12879-020-05701-4","article-title":"Effects of Tocilizumab in COVID-19 patients: a cohort study","volume":"20","author":"CA Vu","year":"2020","journal-title":"BMC Infect Dis"},{"issue":"11","key":"pone.0267283.ref021","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.medcli.2020.05.022","article-title":"Pneumococcal superinfection in COVID-19 patients: A series of 5 cases","volume":"155","author":"D Cucchiari","year":"2020","journal-title":"Med Clin (Barc)"},{"key":"pone.0267283.ref022"},{"issue":"17","key":"pone.0267283.ref023","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1007\/s40265-021-01620-z","article-title":"Casirivimab\/Imdevimab: First Approval","volume":"81","author":"ED Deeks","year":"2021","journal-title":"Drugs"},{"issue":"21","key":"pone.0267283.ref024","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1056\/NEJMoa2107934","article-title":"Early Treatment for Covid-19 with SARS-CoV-2 Neutralizing Antibody Sotrovimab","volume":"385","author":"A Gupta","year":"2021","journal-title":"N Engl J Med"},{"issue":"2","key":"pone.0267283.ref025","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1093\/cid\/ciaa863","article-title":"COVID-19 in Immunocompromised Hosts: What We Know So Far","volume":"72","author":"M Fung","year":"2021","journal-title":"Clin Infect Dis"},{"key":"pone.0267283.ref026","doi-asserted-by":"crossref","first-page":"572329","DOI":"10.3389\/fonc.2020.572329","article-title":"Coronavirus Disease 2019: A Brief Review of the Clinical Manifestations and Pathogenesis to the Novel Management Approaches and Treatments","volume":"10","author":"O Kooshkaki","year":"2020","journal-title":"Front Oncol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0267283","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T18:08:39Z","timestamp":1651169319000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0267283"}},"subtitle":[],"editor":[{"given":"Antonio","family":"Solimando","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,4,28]]},"references-count":26,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0267283","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,28]]}}}