ArticleCureus2025
Comparative Effectiveness of Remdesivir in Hospitalized COVID-19 Patients: A Retrospective Cohort Study From the Pre-vaccination and Omicron Eras.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe real-world effectiveness of remdesivir for COVID-19 pneumonia remains a subject of debate, particularly across different phases of the pandemic. This study compares clinical outcomes and inflammatory biomarker profiles in hospitalized patients treated with remdesivir during two distinct periods: the pre-vaccination era in 2020 and the Omicron-dominant, post-vaccination period in 2023.
methodsThis retrospective observational study was conducted at a tertiary care hospital in Germany. Adults hospitalized with polymerase chain reaction (PCR)-confirmed COVID-19 pneumonia were included from two timeframes: 2020 (n = 154) and 2023 (n = 178). Patients were stratified by remdesivir treatment. The primary outcome was length of hospital stay; secondary outcomes included ICU admission, mechanical ventilation, in-hospital mortality, oxygen requirement, WHO COVID-19 severity grade, and admission inflammatory markers.
resultsIn 2020, 38 patients (24.7%) received remdesivir; in 2023, 64 patients (36.0%) were treated with the drug. Remdesivir use was associated with significantly shorter hospital stays among survivors in both periods (2020: median 10 vs. 20 days; 2023: median 7 vs. 13 days; both p < 0.01). Most treated patients required oxygen and met WHO clinical severity grades 4-6. Inflammatory markers at admission were lower in survivors and the 2023 cohort. In-hospital mortality was 16.9% in 2020 and 9.0% in 2023. A trend toward lower mortality was observed in 2023, although not statistically significant.
conclusionRemdesivir use was consistently associated with reduced hospital stays across both pandemic phases. A potential mortality benefit emerged during the Omicron era, particularly in high-risk patients requiring oxygen, supporting the continued clinical use of remdesivir during periods of high transmission.
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