Ayşegül SEREMET KESKİN, Kübra DEMİR ÖNDER, Filiz KIZILATEŞ

Üçüncü basamak bir hastanede COVID-19 tanılı hastalarda remdesivir deneyimi

Amaç: Remdesivir, COVID-19 tedavi kombinasyonlarında önerilen bir adenozin nükleotid analogu antiviral bir ilaçtır. COVID-19 tedavisinde aşı ve ilaç çalışmaları devam ederken, remdesivir de etkinlik, güvenlik ve olası yan etkiler açısından incelenmektedir. Bu nedenle hastanemizde COVID-19 tanısı alan ve remdesivir ile tedavi edilen hastalarımızın deneyimlerimizi paylaşmayı amaçladık. Gereç ve yöntem: 15 Mart-30 Mart 2020 tarihleri arasında, hastanemize başvuran ve nazofarengeal örneklerden çalışılan RT-PCR testi pozitif olan ve/veya toraks bilgisayarlı tomografi (BT) sonuçlarına göre COVID-19 tanısı alan 18 yaş üstü hastalar retrospektif olarak tarandı. Remdesivir tedavisi alanlar çalışmamıza dahil edildi.Bulgular: Çalışmamıza 23 hasta dahil edildi. Hastaların 18'i (%79,2) erkek, 5'i (%20,8) kadındı. Remdesivir başlama süresi semptomların başlangıcından itibaren 8,4±2,6 gün ve tanı anından itibaren 6±2,6 gündü. Takip döneminde 18 hastayı (%78,2) yoğun bakım ünitesine (YBÜ) yatırmak zorunda kaldık. 14'ünde (%60,8) mekanik ventilatöre ihtiyaç duydu. Tedavi sonrası takiplerinde ise 15 hastanın (%65,2) taburcu edildiği ve 8 hastanın (%34,8) ölümle sonuçlandığını gösterildi.Sonuç: COVID-19 hastalığının patogenezinde virüsün replikasyonu kadar inflamasyon da önemli olduğundan remdesivirin diğer antiviral, antisitokin tedaviler ile kombine şekilde kullanımı ile etkinliğinde artış olabileceği ve bu konuda da yapılacak yeni çalışmalara ihtiyaç olduğu düşünülmüştür.

Anahtar Kelimeler:

COVID-19, remdesivir, tedavi

Remdesivir experience in patients diagnosed with COVID-19 in a tertiary hospital

Purpose: Remdesivir is an adenosine nucleotide analog antiviral drug recommended in these treatment combinations. While vaccine and drug studies are underway in the treatment of COVID-19, remdesivir is also being studied in terms of efficacy, safety, and potential side effects. Therefore, we aimed to share our experiences of patients who were diagnosed with COVID-19 and treated with remdesivir in our hospital.Material method: Patients over 18 years of age, who were diagnosed with COVID-19 in our hospital between March 15 and March 30, 2020, based on positive RT-PCR and/or thoracic computed tomography (CT) results studied from nasopharyngeal samples, were screened retrospectively. Those who had received Remdesivir treatment were included in our study.Results: 23 patients were included in our study. Eighteen (79.2%) of the patients were male and 5 (20.8%) were female. Remdesivir initiation time was 8.4±2.6 days from the onset of symptoms and 6±2.6 days from the time of diagnosis. In the follow-up period, we had to hospitalize 18 patients (78.2%) in the intensive care unit (ICU). 14 (60.8%) needed a mechanical ventilator. Post-treatment follow-up showed that 15 (65.2%) recovered, and 8 (34.8%) resulted in mortality.Conclusion: Since inflammation is as critical as the replication of the virus in the pathogenesis of COVID-19 disease, the use of remdesivir in combination with other antiviral and anti-cytokine therapies may increase the effectiveness. We believe that we need new studies in this regard.

Keywords:

COVID-19, remdesivir, treatment,

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