Predictors of treatment outcomes among critically ill COVID-19 patients on remdesivir-based therapy at Windhoek Central Hospital
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Date
2024
Authors
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Publisher
University of Namibia
Abstract
Introduction: Corona virus disease, caused by the SARS-CoV-2 virus, was declared
a pandemic by WHO in March 2020, with 575 million cases and 6.4 million deaths to
date globally. Remdesivir, a broad-spectrum anti-viral, was one of the few treatment
options available for the management of severe and critical COVID-19 cases. This
study aimed to evaluate predictors of treatment outcomes among critically ill patients
on remdesivir-based therapy at Windhoek Central Hospital.
Methods: A retrospective cohort study reviewed records of patients treated with
remdesivir in the critical care unit at Windhoek Central Hospital from October 2020
to November 2021. Treatment success was defined as being medically stable enough
to be discharged from the hospital within 14 days or being hospitalized but not
requiring any supplemental oxygen nor receiving medical care related to COVID-19
at day 14. Data was analyzed using SPSS version 24 in which Bivariate and
Multivariate regression analyses were performed.
Results: The proportion of males to females was the same (51.9% vs 48.1%). Most
were <65 years old (84.8%), with median age being 53 years. Majority had
undocumented vaccination status (91.1%). About 6.3% had a history of COVID-19.
Some (63.3%) had co-morbidities with hypertension being the most recorded (74%),
followed by diabetes (34%). Majority (86%) required mechanical ventilation at
baseline. Hours before initiation of remdesivir was only recorded in 53 patients. Of
those, remdesivir was initiated within 72 hours in 71.1% of the patients. Fifty-two
percent of the patients were on remdesivir therapy for a duration of 6-10 days while
48% were on therapy for 5 days. Of the 79 records analyzed, there was a 21.5%
treatment success rate. Some (34.2%) had complications with hyperglycemia being the
most recorded (37%) followed by ARDS and anemia both at 33.3%. Bivariate analysis
showed that complications are significantly associated with mortality (p=0.001).
Conclusion: Complications were significantly associated with death among critically
ill COVID-19 patients on remdesivir-based therapy at Windhoek Central Hospital
based on bivariate analysis, although this needs confirmation from multivariate
analysis. Further research on laboratory and radiographic parameters as predictors of
treatment outcomes is essential
Description
A thesis submitted in partial fulfilment of the requirements for the Degree of Master of Pharmacy (Clinical Pharmacy)
Keywords
Remdesivir, Treatment outcomes, Predictors, COVID-19 and Critical, Namibia