Table 1.
Patients’ characteristics and clinical evolution according to treatment received.
| Dexamethasone alone (n = 78) | Remdesivir and dexamethasonea (n = 87) | p | |
|---|---|---|---|
| Demographics and clinical background | |||
| Male sex, n (%) | 47 (60.3) | 42 (48.3) | 0.166 |
| Age, years, mean (SD, range) | 62.3 ± 17.4 (47–70) | 60.0 ± 16.2 (51–74) | 0.396 |
| Age, years range, n (%) | |||
| <40 | 12 (15.4) | 11 (12.6) | 0.672 |
| 40–59 | 18 (23.1) | 25 (28.7) | |
| 60–79 | 34 (43.6) | 40 (46.0) | |
| ≥80 | 14 (17.9) | 11 (12.6) | |
| Origin not Spain (%) | 10 (13.0) | 19 (21.8) | 0.201 |
| Complete vaccinationa | 32 (41) | 42 (47.1) | 0.528 |
| Chronic medical conditionsb, median (IQR) | 1.5 [1.0, 3.0] | 1.0 [0.0, 2.0] | 0.094 |
| Hypertension, n (%) | 41 (52.6) | 39 (44.8) | 0.403 |
| Type 2 Diabetes, n (%) | 22 (28.2) | 24 (27.6) | 1.000 |
| Obesity (body mass index ≥30), n (%) | 25 (32.1) | 24 (27.6) | 0.648 |
| Current tobacco use, n (%) | 9 (11.5) | 8 (9.2) | 0.180 |
| Cardiovascular disease, n (%) | 23 (29.5) | 13 (14.9) | 0.038 |
| Chronic kidney disease, n (%) | 12 (15.4) | 3 (3.4) | 0.017 |
| Pulmonary disease, n (%) | 14 (17.9) | 17 (19.5) | 0.951 |
| Liver disease, n (%) | 7 (9.0) | 2 (2.3) | 0.123 |
| Dementia, n (%) | 5 (6.4) | 2 (2.3) | 0.357 |
| Immunocompromised conditionc, n (%) | 4 (5.1) | 3 (3.4) | 0.883 |
| COVID-19 status at admission | |||
| Days from 1st symptom to admission (mean ± SD) | 6.4 ± 3.9 | 5.4 ± 2.7 | 0.047 |
| CURB-65, n (%) | |||
| 0 | 17 (21.8) | 13 (14.9) | 0.335 |
| 1 | 23 (29.5) | 37 (42.5) | |
| 2 | 28 (35.9) | 29 (33.3) | |
| 3 | 9 (11.5) | 8 (9.2) | |
| 4 | 1 (1.3) | 0 (0.0) | |
| Chest radiology, n (%) | |||
| No infiltrates | 4 (5.1) | 5 (5.7) | 0.329 |
| Unilateral infiltrates | 4 (5.1) | 10 (11.5) | |
| Bilateral infiltrates | 70 (89.7) | 72 (82.8) | |
| SARS-CoV-2 antibody status at admissiond | |||
| SARS-CoV-2 S antibody positive, n (%) | 30 (66.7) | 38 (52.8) | 0.197 |
| SARS-CoV-2 N antibody positive, n (%) | 15 (33.3) | 18 (25.0) | 0.445 |
| Log10 SARS-CoV-2 N antibody UI/ml (mean ± SD) | −0.44 ± 0.9 | −0.45 ± 0.81 | 0.948 |
| Log10 SARS-CoV-2 S antibody UI/ml (mean ± SD) | 2.85 ± 1.46 | 2.55 ± 1.37 | 0.278 |
| Treatments | |||
| Dexamethasone boluses (20 mg/d), n (%) | 43 (55.1) | 36 (41.4) | 0.108 |
| Tocilizumab, n (%) | 20 (25.6) | 18 (20.7) | 0.569 |
| Baricitinib, n (%) | 0 (0.0) | 7 (8.0) | 0.030 |
| LMHW use (%) | 78 (100) | 86(98) | 1 |
| Antibiotics (%) | 46 (59.0) | 28 (32.2) | 0.001 |
| Clinical evolution | |||
| Hospital mean stay (mean ± SD) | 11.1 ± 7.3 | 10.1 ± 6.3 | 0.347 |
| Complications during hospitalizatione, n (%) | 41 (52.6) | 27 (31.0) | 0.008 |
| Radiological worsening | 35 (44.9) | 19 (21.8) | 0.005 |
| ICU admission, n (%) | 31 (40.3) | 15 (17.2) | 0.002 |
| CRP levels, mg/dl median (IQR) | 9.75 [4.9, 13.5] | 7.9 [3.8, 14.8] | 0.297 |
| D-dimer levels, ng/mL, median (IQR) | 1,152 [686, 2445] | 827 [555, 1267] | 0.006 |
| Higher ferritin levels, ng/mL, median (IQR) | 537 [278, 1048] | 438 [268, 849] | 0.253 |
| SaO2/FiO2mmHg (mean ± SD) | 254 ± 135 | 317 ± 113 | 0.002 |
| PaO2/FiO2less than 200 mmHg, n (%) | 29 (46.8) | 18 (22.2) | 0.004 |
| Need for high-flow oxygen, n (%) | 39 (50.0) | 22 (25.3) | 0.002 |
| Need for ventilation, n (%) | 37 (47.4) | 14 (16.1) | <0.001 |
| Need for non-invasive ventilation, n (%) | 37 (47.4) | 14 (16.1) | <0.001 |
| Need for invasive ventilation, n (%) | 10 (12.8) | 5 (5.7) | 0.191 |
| Death, n (%) | 11 (14.1) | 2 (2.3) | 0.012 |
| Time from admission to eventf, days (mean ± SD) | 5.47 (5.38) | 7.75 (5.00) | 0.006 |
| WHO ordinal scale adapted, n (%) | |||
| 2 | 24 (24.0) | 24 (28.6) | 0.006 |
| 3 | 35 (35.0) | 44 (52.4) | |
| 4 | 23 (23.0) | 12 (14.3) | |
| 5 | 8 (8.0) | 4 (4.8) | |
| 6 | 10 (10.0) | 0 (0.0) | |
LMWH: low molecular weight heparin; ICU: intensive care unit; SOFA: sepsis related organ failure assessment.
Complete vaccination when met the following criteria: for Pfizer vaccine, the minimum period between the two doses must be ≥19 days and the period after the 2nd dose to entail risk ≥7 days. For Moderna vaccine, a minimum period between doses of 25 days and a period after the 2nd dose of 14 days. For AstraZeneca vaccine, a minimum period between doses of 21 days and a period after the 2nd dose of 14 days. Finally, for Janssen vaccine, a period of 14 days after vaccination.
Chronic medical conditions included the following: cardiovascular disease, neurologic disease, pulmonary disease, hepatic disease, endocrine disease, kidney disease, hematologic disease, malignancy and immunosuppression.
Immunocompromised condition included active solid cancer (active cancer defined as treatment for the cancer or newly diagnosed cancer in the past 6 months), active hematologic cancer (such as leukemia, lymphoma, or myeloma), HIV infection without AIDS, AIDS, congenital immunodeficiency syndrome, previous splenectomy, previous solid organ transplant, immunosuppressive medication, systemic lupus erythematosus, rheumatoid arthritis, psoriasis, scleroderma, or inflammatory bowel disease (Crohn disease or ulcerative colitis).
SARS-CoV2 serology was determined in 117 patients (72 in remdesivir plus dexamethasone and 45 in dexamethasone alone).
Complications during hospitalization: deep vein thrombosis or pulmonary thromboembolism, bacterial infection, acute renal failure, heart failure, stroke, acute myocardial infarction and elevated transaminases.
Event: need for ventilation or death.