Remdesivir: Real-World Effectiveness and Safety in Individuals Hospitalized for Non-COVID Reasons and Non-Hospitalized High-Risk Patients During the Omicron Era in Greece
2026
Nikos Pantazis | Spyridon Kontos | Evmorfia Pechlivanidou | Nikolaos V. Sipsas | Diamantis Kofteridis | Periklis Panagopoulos | Vassiliki Rapti | Symeon Metallidis | Karolina Akinosoglou | Dimitra Kavatha | Haralampos Milionis | Ioannis Kalomenidis | Ioannis Katsarolis | Vasiliki E. Georgakopoulou | Vasileios Petrakis | Garyfallia Poulakou | Olga Tsachouridou | Markos Marangos | Anastasia Antoniadou | Eleni Polyzou | Eleni Papantoniou | Pinelopi Kazakou | Eirini Christaki | Theofani Rimpa | Sotirios P. Karagiannis | Giota Touloumi
Remdesivir is recommended for hospitalized patients with severe COVID-19 and for those at high risk of progression. Real-world Omicron-era data on incidental COVID-19 and high-risk outpatients remain limited. We conducted a multicenter retrospective cohort study (ReEs-COVID19) in Greece (June&ndash:December 2022) including adults with PCR-confirmed SARS-CoV-2 infection who received remdesivir. Hospitalized patients with incidental COVID-19 (Group A, n = 138) and high-risk outpatients (Group B, n = 312) were analysed. Outcomes included clinical deterioration, mortality, and adverse events. Group A patients were older with more comorbidities. Remdesivir was initiated earlier in Group A (median 1 vs. 2 days) but with a more heterogeneous duration (48.9% vs. 97.8% in Group B, which received the standard 3-day regimen). Clinical deterioration due to COVID-19 occurred in 5.8% vs. 0.6%, and 30-day mortality was 18.1% (25/138) in Group A, including 10 COVID-19-related deaths (7.2%). Group B had two deaths (0.6%), none COVID-19-related. Adverse events were uncommon, with mild kidney injury in 3.6% of Group A and hepatotoxicity in 2.2% vs. 0.3%. In high-risk outpatients, the ReEs-COVID19 study confirmed the effectiveness and safety of remdesivir&rsquo:s profile. Among incidental cases, two distinct disease patterns were identified, associated with different remdesivir regimens and highlighting the importance of comorbidities and the need for tailored clinical interventions.
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