Determinant Factors of Clinical Outcome of Remdesivir for The Treatment of SARS-CoV-2 in Indonesia

Remdesivir is an antiviral approved for treating SARS-CoV-2 patients with moderate to severe symptoms. Remdesivir was effective in shortening the recovery time and preventing the severity of SARS-CoV-2 symptoms. This study aims to evaluate the clinical outcomes, side effects, and determinants that influence the clinical outcomes of remdesivir in treating patients with moderate to severe symptoms in Indonesia. An observational study with a cross-sectional design was conducted at a private hospital in East Java from October to December 2024. Retrospective data were collected through patient medical records and pharmacy reports. The WHO SARS-COV-2 seven-point ordinal clinical progression and recovery scale was used to measure patient clinical outcomes. Multivariate logistic regression analysis was performed to predict determinants of clinical outcomes. Ninety-one patients treated with remdesivir from January 2021 to December 2022 were included. This study found that the clinical outcome of patients who recovered or survived after remdesivir treatment was 52% (n=47). There was no significant improvement in clinical progression on days 1 and 6 among surviving patients (p=0.097). Tachycardia was the most common adverse event (n=58), followed by nausea (n=21) and bradycardia (n=18). Length of hospitalization (p=0.009), progression scale on day 1 of admission (p=0.001), and multivitamin medication (p=0.066) were all associated with patient clinical outcomes. The findings of this study highlight that remdesivir effectively prevents worse clinical progression. Longitudinal studies of post-remdesivir treatment in different locations are warranted.