Background As COVID-19-related mortality remains a concern, optimal management of patients hospitalized for COVID-19 continues to evolve. We developed a population model based on real-world evidence to quantify the clinical impact of increased utilization of remdesivir, the effectiveness of which has been well established in hospitalized patients with COVID-19. Methods The PINC AI healthcare database records for patients hospitalized for COVID-19 from January to December 2023 were stratified by those treated with or without remdesivir (“RDV” and “No RDV”) and by supplemental oxygen requirements: no supplemental oxygen charges (NSOc), low-flow oxygen (LFO), and high-flow oxygen/non-invasive ventilation (HFO/NIV). Key vulnerable subgroups such as elderly and immunocompromised patients were also evaluated. The model applied previously published hazard ratios (HRs) to 28-day in-hospital mortality incidence to determine the number of potential lives saved if additional “No RDV” patients had been treated with remdesivir upon hospital admission. Results Of 84,810 hospitalizations for COVID-19 in 2023, 13,233 “No RDV” patients were similar in terms of characteristics and clinical presentation to the “RDV” patients. The model predicted that initiation of remdesivir in these patients could have saved 231 lives. Projected nationally, this translates to >800 potential lives saved (95% CI: 469-1,126). Eighty-nine percent of potential lives saved were elderly and 19% were immunocompromised individuals. Seventy-one percent were among NSOc or LFO patients. Conclusions This public health model underscores the value of initiating remdesivir upon admission in patients hospitalized for COVID-19, in accordance with evidence-based best practices, to minimize lives lost due to SARS-CoV-2 infection.

中文翻译：

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应用循证最佳实践来管理 COVID-19 住院患者的公共卫生益处


背景 由于 COVID-19 相关死亡率仍然是一个问题，因此 COVID-19 住院患者的最佳管理不断发展。我们开发了一个基于真实世界证据的人群模型，以量化瑞德西韦使用增加的临床影响，其有效性已在 COVID-19 住院患者中得到充分证实。方法 2023 年 1 月至 12 月因 COVID-19 住院的患者的 PINC AI 医疗保健数据库记录按接受或不接受瑞德西韦治疗的患者（“RDV”和“无 RDV”）和补充氧气需求分层：无补充氧气费用 （NSOc）、低流量氧气 （LFO） 和高流量氧气/无创通气 （HFO/NIV）。还评估了老年人和免疫功能低下患者等关键弱势亚组。该模型将先前发表的风险比 （HRs） 与 28 天院内死亡率相结合，以确定如果其他“无 RDV”患者在入院时接受瑞德西韦治疗，可能挽救的生命数量。结果 在 2023 年的 84,810 例 COVID-19 住院患者中，13,233 例“无 RDV”患者在特征和临床表现方面与“RDV”患者相似。该模型预测，在这些患者中开始使用瑞德西韦可以挽救 231 人的生命。在全国范围内预测，这意味着可能挽救 >800 人的生命 （95% CI： 469-1,126）。89% 的潜在生命是老年人，19% 是免疫功能低下的人。71% 的患者为 NSOc 或 LFO 患者。 结论 这种公共卫生模式强调了根据循证最佳实践，在 COVID-19 住院患者入院时开始使用瑞德西韦的价值，以最大限度地减少因 SARS-CoV-2 感染而造成的生命损失。