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Research suggests COVID-19 treatment remdesivir increases hospital stay, does little to improve survival

Researchers are concerned an individual may be kept in a hospital for too long while receiving the treatment, making it harder for others to find a bed.

IOWA CITY, Iowa — Editor's Note: The video above is from May 11, 2020. 

A University of Iowa study conducted on U.S. veterans hospitalized with COVID-19 found a treatment frequently used on patients battling the novel coronavirus was not associated with survival but was associated with longer hospital stays. 

The U.S. Food and Drug Administration approved remdesivir last October for treating coronavirus cases. The antiviral medicine given through an IV was the first to be approved by the FDA. 

Research led by Michael Ohl, MD, MSPH, associate professor of internal medicine at the UI Carver College of Medicine, found the new study contradicted previous clinical trials of the drug which suggested remdesivir would shorten recovery time for those hospitalized from COVID. 

However, there was little information during the initial clinical trials about the impact of the treatment on survival and length of hospital stays for patients in a "real world" care setting, according to Ohl. 

Ohl, who is also a physician with the Iowa City Veterans Affairs Health Care System, used recent national data from the Veterans Health Administration to examine those factors among veterans with the virus. 

The observational study tracked 2,344 hospitalized adults with COVID from 123 different VA hospitals. Of those people, half received remdesivir and the other was observed as a control group. 

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Ohl's research found remdesivir therapy "was not associated with improved 30-day survival, but was associated with a 3-day increase in median time to hospital discharge— a significant difference."

The drug is still widely used in hospitals nationwide, including at UI Hospitals and Clinics.

Ohl's research notes that since the approval of the drug, UI Health Care physicians have been careful to assure patients with COVID are not kept in the hospital solely to complete their treatment if they are otherwise ready for discharge. 

“So, the length of stay issue we saw in the paper is probably not significant at UI Hospitals and Clinics,” Ohl said. “That said, I think the practice of keeping patients in a hospital to complete remdesivir courses may still be an issue at other hospitals around the country.”

Of course, there are limitations to this study. The 1,172 individuals who received the remdesivir treatment were patients who could be matched to controls who did not receive the treatment. 

These patients represented only about half of the total 2,374 VA patients who received the drug, and they "had a lower propensity for remdesivir treatment and less severe illness compared with remdesivir recipients who were not able to be matched with control patients." 

This means the results of this study may not be generalizable to all patients who receive remdesivir. 

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