The kinetics of SARS-CoV-2 viremia in COVID-19 patients receiving remdesivir.

Krifors A, Karlsson L, Ekman M, Lorant C, Skorup P

Eur J Clin Microbiol Infect Dis 42 (8) 951-958 [2023-08-00; online 2023-05-27]

Detection of SARS-CoV-2 RNA in serum, viremia, has been linked to disease severity and outcome. The kinetics of viremia in patients receiving remdesivir has not been thoroughly studied and could help predict treatment response and outcome. We investigated the kinetics of SARS-CoV-2 viremia and factors associated with baseline viremia, viral clearance and 30-day mortality in patients receiving remdesivir. An observational study including 378 hospitalised patients (median age 67 years, 67% male) sampled with serum SARS-CoV-2 RT-PCR within ± 24 h of initiation of remdesivir treatment. Baseline viremia was present in 206 (54%) patients with a median Ct value of 35.3 (IQR = 33.3-37.1). In patients with baseline viremia, the estimated probability of viral clearance was 72% by day 5. Ct values decreased significantly during remdesivir treatment for viremic patients, indicating an increase in viral load. In total, 44 patients (12%) died within 30 days, and mortality was significantly associated with viremia at baseline (OR = 2.45, p = 0.01) and lack of viral clearance by day 5 (OR = 4.8, p = < 0.01). Viral clearance was not associated with any individual risk factor. Viremia appears to be a prognostic marker before and during remedesivir treatment. The resolution of viremia was similar to patients not receiving remdesivir in other studies, and the decrease in Ct values during treatment questions the antiviral capacity of remdesivir in vivo. Prospective studies are warranted to confirm our findings.

Category: Biochemistry

Category: Genomics & transcriptomics

Category: Health

Category: Public Health

Type: Journal article

PubMed 37243828

DOI 10.1007/s10096-023-04627-4

Crossref 10.1007/s10096-023-04627-4

pmc: PMC10224642
pii: 10.1007/s10096-023-04627-4

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