[Source: Clinical Infectious Diseases, full page: (LINK). Abstract, edited.]
Compassionate Use of Remdesivir in Pregnant Women with Severe Covid-19
Richard M Burwick, Sigal Yawetz, Kathryn E Stephenson, Ai-Ris Y Collier, Pritha Sen, Brian G Blackburn, E Milunka Kojic, Adi Hirshberg, Jose F Suarez, Magdalena E Sobieszczyk, Kristen M Marks, Shawn Mazur, Cecilia Big, Oriol Manuel, Gregory Morlin, Suzanne J Rose, Mariam Naqvi, Ilona T Goldfarb, Adam DeZure, Laura Telep, Susanna K Tan, Yang Zhao, Tom Hahambis, Jason Hindman, Anand P Chokkalingam, Christoph Carter, Moupali Das, Anu O Osinusi, Diana M Brainard, Tilly A Varughese, Olga Kovalenko, Matthew D Sims, Samit Desai, Geeta Swamy, Jeanne S Sheffield, Rebecca Zash, William R Short
Clinical Infectious Diseases, ciaa1466, https://doi.org/10.1093/cid/ciaa1466
Published: 08 October 2020
Abstract
Background
Remdesivir is efficacious for severe COVID-19 in adults, but data in pregnant women are limited. We describe outcomes in the first 86 pregnant women with severe COVID-19 who were treated with remdesivir.
Methods
Reported data span March 21 to June 16, 2020 for hospitalized pregnant women with PCR-confirmed SARS-CoV-2 infection and room air oxygen saturation ≤94% whose clinicians requested remdesivir through the compassionate use program. The intended remdesivir treatment course was 10 days (200mg on Day 1, followed by 100mg for Days 2-10, given intravenously).
Results
Nineteen of 86 women delivered before their first dose and were reclassified as immediate “postpartum” (median postpartum day=1; range 0-3). At baseline, 40% of pregnant women (median gestational age 28 weeks) required invasive ventilation, in contrast to 95% of postpartum women (median gestational age at delivery 30 weeks). By Day 28 of follow-up, the level of oxygen requirement decreased in 96% and 89% of pregnant and postpartum women, respectively. Among pregnant women, 93% of those on mechanical ventilation were extubated, 93% recovered, and 90% were discharged. Among postpartum women, 89% were extubated, 89% recovered, and 84% were discharged. Remdesivir was well tolerated, with a low incidence of serious adverse events (16%). Most adverse events were related to pregnancy and underlying disease; most laboratory abnormalities were Grades 1 or 2. There was one maternal death attributed to underlying disease and no neonatal deaths.
Conclusions
Among 86 pregnant and postpartum women with severe COVID-19 who received compassionate use remdesivir, recovery rates were high, with a low rate of serious adverse events.
remdesivir, pregnant, COVID-19, ventilation, recovery
Issue Section: Major Article
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© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
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Keywords: SARS-CoV-2; COVID-19; Antivirals; Remdesivir; Pregnancy.
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