ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025
Lower Mortality Risk Associated With Remdesivir + Dexamethasone Versus Dexamethasone Alone for the Treatment of Patients Hospitalized for COVID-19.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- The CCR2 inflammatory pathway is a target for improving severe disease and pulmonary inflammation in experimental COVID-19.Virulence · 2026Article
- Corticosteroids with or without antiviral therapy in elderly patients hospitalized with COVID-19 during the Omicron era: A multicenter real-world study.Journal of virus eradication · 2026Article
- Lower mortality risk associated with remdesivir plus corticosteroids vs corticosteroids alone for the treatment of patients hospitalized with SARS-CoV-2 infection in the early and later Omicron periods.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2026Article
- Evaluating treatment effectiveness: Complementing RCTs with real-world data.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2026Article
- Article
- Dexamethasone treatment does not alter mortality but reduces pulmonary pathology in Nipah virus-infected Syrian hamsters.Antiviral research · 2025Article
- The clinical impact of prolonged steroid therapy in severe COVID-19 patients: a retrospective cohort study with propensity score matching.BMC pulmonary medicine · 2025Article
- Risk of Severe COVID-19 in Four Immunocompromised Populations: A French Expert Perspective.Infectious diseases and therapy · 2025Review
- Carbon monoxide potentiates the effect of corticosteroids in suppressing inflammatory responses in cell culture.Bioorganic & medicinal chemistry · 2025Article
- Impact of COVID-19 therapeutics on the development of post-infectious lung fibrosis.Frontiers in microbiology · 2025Article
- Public Health Benefits of Applying Evidence-Based Best Practices in Managing Patients Hospitalized for COVID-19.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
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Funding
Abstract
backgroundTreatment guidelines were developed early in the pandemic when much about coronavirus disease 2019 (COVID-19) was unknown. Given the evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), real-world data can provide clinicians with updated information. The objective of this analysis was to assess mortality risk in patients hospitalized for COVID-19 during the Omicron period receiving remdesivir + dexamethasone versus dexamethasone alone.
methodsA large, multicenter US hospital database was used to identify adult patients hospitalized with a primary discharge diagnosis of COVID-19 flagged as "present-on-admission" and treated with remdesivir + dexamethasone or dexamethasone alone between December 2021 and April 2023. Patients were matched using 1:1 propensity score matching and stratified by baseline oxygen requirements. Cox proportional hazards model was used to assess time to 14- and 28-day in-hospital all-cause mortality.
resultsA total of 33 037 patients were matched, with most patients ≥65 years old (72%), White (78%), and non-Hispanic (84%). Remdesivir + dexamethasone was associated with lower mortality risk versus dexamethasone alone across all baseline oxygen requirements at 14-days (no supplemental oxygen charges: adjusted hazard ratio [95% confidence interval {CI}]: 0.79 [.72-.87], low flow oxygen: 0.70 [.64-.77], high flow oxygen/non-invasive ventilation: 0.69 [.62-.76], invasive mechanical ventilation/extracorporeal membrane oxygen (IMV/ECMO): 0.78 [.64-.94]), with similar results at 28-days.
conclusionsRemdesivir + dexamethasone was associated with a significant reduction in 14- and 28-day mortality compared to dexamethasone alone in patients hospitalized for COVID-19 across all levels of baseline respiratory support, including IMV/ECMO. However, the use of remdesivir + dexamethasone still has low clinical practice uptake. In addition, these data suggest a need to update the existing guidelines.
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