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Case report study of the first five COVID-19 patients treated with remdesivir in France.
Int J Infect Dis. 2020 Sep; 98:290-293.IJ

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been identified as the virus responsible for the coronavirus disease 2019 (COVID-19) outbreak worldwide. Data on treatment are scare and parallels have been made between SARS-CoV-2 and other coronaviruses. Remdesivir is a broad-spectrum antiviral with efficient in vitro activity against SARS-CoV-2. Evidence of clinical improvement in patients with severe COVID-19 treated with remdesivir is controversial. The aim of this study was to describe the clinical outcomes and virological monitoring of the first five COVID-19 patients admitted to the intensive care unit of Bichat-Claude Bernard University Hospital, Paris, France, for severe pneumonia related to SARS-CoV-2 and treated with remdesivir. Quantitative reverse transcription PCR was used to monitor SARS-CoV-2 in blood plasma and the lower and upper respiratory tract. Among the five patients treated, two needed mechanical ventilation and one needed high-flow cannula oxygen. A significant decrease in SARS-CoV-2 viral load in the upper respiratory tract was observed in most cases, but two patients died with active SARS-CoV-2 replication in the lower respiratory tract. Plasma samples were positive for SARS-CoV-2 in only one patient. Remdesivir was interrupted before the initialy planned duration in four patients, two because of alanine aminotransferase elevations (3 to 5 normal range) and two because of renal failure requiring renal replacement. This case series of five COVID-19 patients requiring intensive care unit treatment for respiratory distress and treated with remdesivir, highlights the complexity of remdesivir use in such critically ill patients.

Authors+Show Affiliations

AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France. Electronic address: marie.dubert@aphp.fr.AP-HP. Nord, Virology Department, Bichat-Claude Bernard University Hospital, Paris, France; University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France.AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France.University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France; AP-HP. Nord, Medical and Infectious Diseases Intensive Care Unit, Bichat-Claude Bernard University Hospital, Paris, France.AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France.University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France; AP-HP. Nord, Medical and Infectious Diseases Intensive Care Unit, Bichat-Claude Bernard University Hospital, Paris, France.University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France; AP-HP. Nord, Medical and Infectious Diseases Intensive Care Unit, Bichat-Claude Bernard University Hospital, Paris, France.AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France.AP-HP. Nord, Pharmacy Unit, Bichat-Claude Bernard University Hospital, Paris, France.AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France.AP-HP. Nord, Virology Department, Bichat-Claude Bernard University Hospital, Paris, France; University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France.AP-HP. Nord, Virology Department, Bichat-Claude Bernard University Hospital, Paris, France.AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France; University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France.AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France; University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France.AP-HP. Nord, Infectious and Tropical Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France; University of Paris, French Institute for Health and Medical Research (INSERM), IAME, U1137, Team DesCID, Paris, France.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32619764

Citation

Dubert, Marie, et al. "Case Report Study of the First Five COVID-19 Patients Treated With Remdesivir in France." International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, vol. 98, 2020, pp. 290-293.
Dubert M, Visseaux B, Isernia V, et al. Case report study of the first five COVID-19 patients treated with remdesivir in France. Int J Infect Dis. 2020;98:290-293.
Dubert, M., Visseaux, B., Isernia, V., Bouadma, L., Deconinck, L., Patrier, J., Wicky, P. H., Le Pluart, D., Kramer, L., Rioux, C., Le Hingrat, Q., Houhou-Fidouh, N., Yazdanpanah, Y., Ghosn, J., & Lescure, F. X. (2020). Case report study of the first five COVID-19 patients treated with remdesivir in France. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, 98, 290-293. https://doi.org/10.1016/j.ijid.2020.06.093
Dubert M, et al. Case Report Study of the First Five COVID-19 Patients Treated With Remdesivir in France. Int J Infect Dis. 2020;98:290-293. PubMed PMID: 32619764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Case report study of the first five COVID-19 patients treated with remdesivir in France. AU - Dubert,Marie, AU - Visseaux,Benoit, AU - Isernia,Valentina, AU - Bouadma,Lila, AU - Deconinck,Laurène, AU - Patrier,Juliette, AU - Wicky,Paul-Henri, AU - Le Pluart,Diane, AU - Kramer,Laura, AU - Rioux,Christophe, AU - Le Hingrat,Quentin, AU - Houhou-Fidouh,Nadhira, AU - Yazdanpanah,Yazdan, AU - Ghosn,Jade, AU - Lescure,Francois-Xavier, Y1 - 2020/06/30/ PY - 2020/05/12/received PY - 2020/06/26/revised PY - 2020/06/26/accepted PY - 2020/7/4/pubmed PY - 2020/9/22/medline PY - 2020/7/4/entrez KW - Antiviral therapy KW - Case reports KW - Remdesivir KW - SARS-CoV-2 viral load KW - Viral pneumonia SP - 290 EP - 293 JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases JO - Int J Infect Dis VL - 98 N2 - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been identified as the virus responsible for the coronavirus disease 2019 (COVID-19) outbreak worldwide. Data on treatment are scare and parallels have been made between SARS-CoV-2 and other coronaviruses. Remdesivir is a broad-spectrum antiviral with efficient in vitro activity against SARS-CoV-2. Evidence of clinical improvement in patients with severe COVID-19 treated with remdesivir is controversial. The aim of this study was to describe the clinical outcomes and virological monitoring of the first five COVID-19 patients admitted to the intensive care unit of Bichat-Claude Bernard University Hospital, Paris, France, for severe pneumonia related to SARS-CoV-2 and treated with remdesivir. Quantitative reverse transcription PCR was used to monitor SARS-CoV-2 in blood plasma and the lower and upper respiratory tract. Among the five patients treated, two needed mechanical ventilation and one needed high-flow cannula oxygen. A significant decrease in SARS-CoV-2 viral load in the upper respiratory tract was observed in most cases, but two patients died with active SARS-CoV-2 replication in the lower respiratory tract. Plasma samples were positive for SARS-CoV-2 in only one patient. Remdesivir was interrupted before the initialy planned duration in four patients, two because of alanine aminotransferase elevations (3 to 5 normal range) and two because of renal failure requiring renal replacement. This case series of five COVID-19 patients requiring intensive care unit treatment for respiratory distress and treated with remdesivir, highlights the complexity of remdesivir use in such critically ill patients. SN - 1878-3511 UR - https://www.unboundmedicine.com/medline/citation/32619764/Case_report_study_of_the_first_five_COVID_19_patients_treated_with_remdesivir_in_France_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(20)30528-2 DB - PRIME DP - Unbound Medicine ER -