Remdesivir Effectiveness in Reducing the Risk of 30-day Readmission in Vulnerable Patients Hospitalized for COVID-19: A Retrospective US Cohort Study Using Propensity Scores

IF 8.2 1区 医学 Q1 IMMUNOLOGY Clinical Infectious Diseases Pub Date : 2024-10-15 DOI:10.1093/cid/ciae511
Essy Mozaffari, Aastha Chandak, Robert L Gottlieb, Andre C Kalil, Heng Jiang, Thomas Oppelt, Mark Berry, Chidinma Chima-Melton, Alpesh N Amin
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Abstract

Background Reducing hospital readmission offer potential benefits for patients, providers, payers, and policymakers to improve quality of healthcare, reduce cost, and improve patient experience. We investigated effectiveness of remdesivir in reducing 30-day COVID-19-related readmission during the Omicron era, including older adults and those with underlying immunocompromising conditions. Methods This retrospective study utilized the US PINC AI Healthcare Database to identify adult patients discharged alive from an index COVID-19 hospitalization between December 01, 2021 and February 29, 2024. Odds of 30-day COVID-19-related readmission to the same hospital were compared between patients who received remdesivir vs those not, after balancing characteristics of two groups using inverse probability of treatment weighting (IPTW). Analyses were stratified by maximum supplemental oxygen requirement during index hospitalization. Results Of 326,033 patients hospitalized for COVID-19 during study period, 210,586 patients met the eligibility criteria. Of these, 109,551 (52%) patients were treated with remdesivir. After IPTW, lower odds of 30-day COVID-19-related readmission were observed in patients who received remdesivir vs those who did not, in the overall population (3.3% vs 4.2%, respectively; odds ratio [95% confidence interval]: 0.78 [0.75–0.80]), elderly population (3.7% vs 4.7%, respectively; 0.78 [0.75–0.81]), and those with underlying immunocompromising conditions (5.3% vs 6.2%, respectively; 0.86 [0.80–0.92]). These results were consistent irrespective of supplemental oxygen requirements. Conclusions Treating patients hospitalized for COVID-19 with remdesivir was associated with a significantly lower likelihood of 30-day COVID-19-related readmission across all patients discharged alive from the initial COVID-19 hospitalization, including older adults and those with underlying immunocompromising conditions.
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雷米地韦能有效降低因 COVID-19 而住院的高危患者 30 天内再次入院的风险:使用倾向评分的美国队列回顾性研究
背景 降低再入院率可为患者、医疗服务提供者、支付者和政策制定者带来潜在的益处,从而提高医疗质量、降低成本并改善患者体验。我们调查了在 Omicron 时代雷米替韦在减少 30 天 COVID-19 相关再入院方面的有效性,包括老年人和有潜在免疫力低下情况的患者。方法 这项回顾性研究利用美国 PINC AI 医疗保健数据库来识别 2021 年 12 月 1 日至 2024 年 2 月 29 日期间从 COVID-19 指征住院治疗中存活出院的成年患者。使用反向治疗概率加权法(IPTW)平衡两组患者的特征后,比较了接受雷米替韦治疗与未接受雷米替韦治疗的患者在 30 天内再次入院接受 COVID-19 相关治疗的几率。分析按住院期间最大补氧需求进行分层。结果 在研究期间因 COVID-19 住院的 326,033 名患者中,有 210,586 名患者符合资格标准。其中,109551 名患者(52%)接受了雷米替韦治疗。IPTW治疗后,在总体人群中,接受雷米替韦治疗的患者与未接受雷米替韦治疗的患者相比,30天内COVID-19相关再入院的几率更低(分别为3.3% vs 4.2%;几率比[95%置信区间]:0.78 [0.75-0.75] [0.78-0.75]):0.78[0.75-0.80])、老年人群(分别为 3.7% vs 4.7%;0.78[0.75-0.81])和有潜在免疫力低下症状的人群(分别为 5.3% vs 6.2%;0.86[0.80-0.92])。无论是否需要补充氧气,这些结果都是一致的。结论 对因COVID-19住院的患者使用雷米替韦治疗与COVID-19相关的30天再入院的可能性显著降低。
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来源期刊
Clinical Infectious Diseases
Clinical Infectious Diseases 医学-传染病学
CiteScore
25.00
自引率
2.50%
发文量
900
审稿时长
3 months
期刊介绍: Clinical Infectious Diseases (CID) is dedicated to publishing original research, reviews, guidelines, and perspectives with the potential to reshape clinical practice, providing clinicians with valuable insights for patient care. CID comprehensively addresses the clinical presentation, diagnosis, treatment, and prevention of a wide spectrum of infectious diseases. The journal places a high priority on the assessment of current and innovative treatments, microbiology, immunology, and policies, ensuring relevance to patient care in its commitment to advancing the field of infectious diseases.
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