The Efficacy of Remdesivir in Shortening ICU Stay for COVID-19: A Retrospective Analysis.

Abstract

Introduction:
The COVID-19 pandemic has placed immense strain on intensive care units (ICUs) globally. Several studies have shown that pre-existing respiratory comorbidities increase the risk of adverse outcomes in COVID-19 patients requiring ICU care. However, data on the specific impact of respiratory comorbidities on ICU outcomes remains limited.

Methods:
This retrospective study analyzed data from 1387 COVID-19 patients admitted to the ICUs of four tertiary care hospitals in Saudi Arabia between  22 June 2020 and 22 October 2020. The effect of pre-existing respiratory conditions including asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung disease (ILD) on length of ICU stay, mechanical ventilation duration, and discharge outcomes was evaluated. IBM SPSS version 28.0 for windows was used for data analysis. Descriptive statistics were employed to summarize demographic variables, outcomes, and comorbidities, providing a detailed profile of the study population using frequency and percentage for categorical variables and mean ± SD for continuous variables. Subsequently, chi-square tests were applied to investigate associations between categorical variables. The Mann-Whitney U test was used to explore the significance of association between numerical variables. All tests were two sided and a P-value of less than 0.05 was significant.

Results:
This retrospective study analyzed data from 1387 COVID-19 patients admitted to the ICUs of four tertiary care hospitals in Saudi Arabia between June 2023 to January 2024. The mean age was 56 years and 74% were male. Around 46% were healthcare workers. Pre-existing respiratory comorbidities were present in 241 (17.4%) patients, including asthma (8.6%), COPD (6.3%), and ILD (2.5%). Patients with respiratory comorbidities had significantly longer mean ICU stays (16 vs 13 days, p=0.001) and mechanical ventilation durations (12 vs 9 days, p<0.001). They were also less likely to be discharged home from the ICU (47.3% vs 55.1%, p=0.04) and had higher mortality rates (46.1% vs 38.1%, p=0.02).

Conclusion:
This study demonstrates that pre-existing respiratory diseases significantly increase the ICU burden and negatively impact outcomes of COVID-19 patients requiring intensive care. Strategies to optimize management of respiratory comorbidities may help improve prognosis. Further large-scale investigations are warranted to better understand this association and inform tailored clinical approaches.