A Study to Analyse the Effect of Remdesivir on Clinical and Immunological Profiles in Moderate COVID-19 Patients
Abstract
Introduction: COVID-19, caused by SARS-CoV-2, has become a global pandemic. Various drugs have been used to manage this disease.
Aim: This study examines the effect of remdesivir on clinical and immunological profiles in moderate COVID-19 patients.
Methods and Material: This prospective cross-sectional study was conducted at Maulana Azad Medical College. We enrolled 50 moderate COVID-19 patients without renal or hepatic disease. Patients received daily remdesivir for 5 days and were monitored for 7 days. Clinical assessment used NEWS 2 scoring, and immunological profiles were measured by IL-6, CRP, D-dimer, PCT, and serum ferritin tests. Data were analyzed with SPSS version 25 and Pearson correlation.
Results: Remdesivir improved clinical and immunological profiles. NEWS 2 scores improved over 7 days. CRP and IL-6 levels decreased, while D-dimer, procalcitonin, and ferritin trends varied between recovered and worsening patients. D-dimer, serum ferritin, and procalcitonin levels improved in moderate cases but worsened in severe cases.
Conclusion: NEWS 2 score was an effective clinical status marker. CRP, IL-6, D-dimer, and serum ferritin were reliable disease severity markers, higher in severe and deteriorating patients. PCT was useful for early bacterial infection detection. The relevance of remdesivir in COVID-19 outcomes remains debated, with mixed study results.
How to cite this article:
Jakhar R, Garg S, B C Koner, Aggarwal S, Bharti
P, George N, Malla R D .J Adv Res Med 2022;
9(4): 11-18.
DOI : https://doi.org/10.24321/2349.7181.202216
References
Cui J, Li F, Shi ZL. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019;17(3):181-92.
[PubMed] [Google Scholar]
Drosten C, Günther S, Preiser W, van der Werf S, Brodt HR, Becker S, Rabenau H, Panning M, Kolesnikova L,
Fouchier RA, Berger A, Burguière AM, Cinatl J, Eickmann M, Escriou N, Grywna K, Kramme S, Manuguerra JC,
Müller S, Rickerts V, Stürmer M, Vieth S, Klenk HD, Osterhaus AD, Schmitz H, Doerr HW. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. N Engl J Med. 2003;348(20):1967-76. [PubMed] [Google Scholar]
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D,
Xu W, Wu G, Gao GF, Tan W; China Novel Coronavirus Investigating and Research Team. A novel coronavirus
from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33. [PubMed] [Google Scholar]
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DS, Du B, Li LJ, Zeng G, Yuen KY,
Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng
P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS; China Medical Treatment
Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. [PubMed] [Google Scholar]
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S,
Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in
Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. [PubMed] [Google Scholar]
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng
Z. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in
Wuhan, China. JAMA. 2020;323(11):1061-9. [PubMed] [Google Scholar]
Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, Wu Y, Zhang L, Yu Z, Fang M, Yu T, Wang Y, Pan S, Zou X, Yuan S,
Shang Y. Clinical course and outcomes of critically vill patients with SARS-CoV-2 pneumonia in Wuhan,
China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475-81. [PubMed]
[Google Scholar]
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X,
Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features
of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
[PubMed] [Google Scholar]
Vijayvargiya P, Garrigos ZE, Almeida NE, Gurram PR, Stevens RW, Razonable RR. Treatment considerations
for COVID-19: a critical review of the evidence (or lack thereof). Mayo Clin Proc. 2020;95(7):1454-66.
[PubMed] [Google Scholar]
Antinori S, Cossu MV, Ridolfo AL, Rech R, Bonazzetti C, Pagani G, Gubertini G, Coen M, Magni C, Castelli A,
Borghi B, Colombo R, Giorgi R, Angeli E, Mileto D, Milazzo L, Vimercati S, Pellicciotta M, Corbellino M, Torre A,
Rusconi S, Oreni L, Gismondo MR, Giacomelli A, Meroni L, Rizzardini G, Galli M. Compassionate remdesivir
treatment of severe Covid-19 pneumonia in intensive care unit (ICU) and non-ICU patients: clinical outcome
and differences in post-treatment hospitalisation status. Pharmacol Res. 2020 Aug;158:104899. [PubMed]
[Google Scholar]
Ader F, Bouscambert-Duchamp M, Hites M, PeifferSmadja N, Poissy J, Belhadi D, Diallo A, Lê MP, Peytavin
G, Staub T, Greil R, Guedj J, Paiva JA, Costagliola D, Yazdanpanah Y, Burdet C, Mentré F; DisCoVeRy Study
Group. Remdesivir plus standard of care versus standard of care alone for the treatment of patients admitted
to hospital with COVID-19 (DisCoVeRy): a phase 3, randomised, controlled, open-label trial. Lancet Infect
Dis. 2022 Feb;22(2):209-21. [PubMed] [Google Scholar]
Sixt T, Moretto F, Devilliers H, Abdallahoui M, Eberl I, Rogier T, Duong M, Salmon-Rousseau A, Mahy S,
Buisson M, Esteve C, Chavanet P, Catherine FX, Blot M, Piroth L. The usefulness of NEWS2 at day 7 of
hospitalization in predicting COVID-19 evolution and as an early endpoint in therapeutic trials. J Infect. 2021
Feb 1;82(2):282-327. [PubMed] [Google Scholar]
Stoeckle K, Witting B, Kapadia S, An A, Marks K. Elevated inflammatory markers are associated with poor
Copyright (c) 2022 Rajesh Jakhar, Sandeep Garg , B. C. Koner, Sunita Aggarwal, Praveen Bharti, Namita George, Deepak Ranjan Malla
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
