Public health benefits of applying evidence-based best practices in managing patients hospitalized for COVID-19
File(s)
Published version
OA Location
Author(s)
Type
Journal Article
Abstract
Background
As coronavirus disease 2019 (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. 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% confidence interval, 469–1126). Eighty-nine percent of potential lives saved were elderly and 19% were immunocompromised individuals. Seventy-six 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 because of severe acute respiratory syndrome coronavirus 2 infection.
As coronavirus disease 2019 (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. 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% confidence interval, 469–1126). Eighty-nine percent of potential lives saved were elderly and 19% were immunocompromised individuals. Seventy-six 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 because of severe acute respiratory syndrome coronavirus 2 infection.
Date Issued
2024-12-15
Date Acceptance
2024-10-01
Citation
Clinical Infectious Diseases, 2024, 79 (Supplement_4), pp.S160-S166
ISSN
1058-4838
Publisher
Oxford University Press
Start Page
S160
End Page
S166
Journal / Book Title
Clinical Infectious Diseases
Volume
79
Issue
Supplement_4
Copyright Statement
© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distri bution, and reproduction in any medium, provided the original work is properly cited. https://doi.org/10.1093/cid/ciae517
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39449663
PII: 7840723
Subjects
COVID-19 model
data science
dexamethasone
Immunology
Infectious Diseases
Life Sciences & Biomedicine
Microbiology
mortality
real world data
remdesivir
SARS-CoV-2
Science & Technology
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2024-10-25