Remdesivir in COVID-19
중증 코로나바이러스감염증 입원 환자에서 가능한 경우 렘데시비르를 권고합니다.
● For hospitalized patients with severe COVID-19, we recommend remdesivir, if available (Grade 1B).
코로나바이러스감염이 확진되고 폐침범이 있었던 1000명 이상을 대상으로 한 다국가시험 예비보고에서 렘데시비르는 위약 15일보다 빠른 회복 (평균 11일)을 나타냈습니다. 낮은 사망률 경향은 통계적 의미가 없었습니다. 가장 분명한 이득은 저산소증 또는 산소공급을 필요로 하지만 기관삽관을 하지 않은 중증 질환 환자에서 있었습니다.
Remdesivir is an investigational antiviral agent under evaluation for COVID-19. In a preliminary report of a multinational trial of >1000 patients with confirmed COVID-19 and pulmonary involvement, remdesivir resulted in faster time to recovery (median 11 versus 15 days with placebo); a trend towards lower mortality was not statistically significant (7 versus 12 percent) [1]. The most evident benefit was in patients who had severe illness (hypoxia or need for supplemental oxygen) but were not yet intubated. In contrast, in a randomized trial from China of 237 patients with severe COVID-19, remdesivir and placebo had similar times to clinical improvement (median 21 versus 23 days) and mortality rates (14 versus 13 percent); however, confidence in the finding of no effect was reduced by use of concomitant therapies, differences in baseline comorbidities between the groups, and failure to meet the target enrollment [2]. The United States Food and Drug Administration granted an emergency use authorization for remdesivir in hospitalized patients with severe COVID-19; if available, we recommend remdesivir for such patients and also refer them for trials of other agents, if concurrent remdesivir use is allowed.
REF, UpToDate 2020.06.08
