Better post-acute sequelae COVID19 observed in hospitalized COVID19 patients treated with remdesivir

Post acute sequelae COVID19 (PASC) is still an ill-defined condition, mainly characterized by persisting symptoms following infection. Remdesivir (RDV) has been widely used as antiviral treatment for hospitalized patients needing oxygen therapy. Our aim was to evaluate the role of RDV in previously hospitalized PACS patients, assessing symptoms, pulmonary functions (PF) and quality of life (QoL). Former inpatients (N=293) presenting to post-COVID pulmonary care between 01/02/2021-03/02/2023 were categorized based on receiving RDV (N=183) or only standard of care (SOC; N=110). Patient characteristics, symptoms during and after COVID19, applied therapies, detailed PF, 6-minute walk test (6MWT), QoL were registered. Age (57.4±14.2 vs. 58.6±14.1 years) and sex (female 36.1 vs. 39.1%) were similar in both groups. Length of hospital stay was significantly shorter in RDV-group (14±13 vs. 19±19 days, p=0.022). During COVID19 more patients required oxygen in RDV-group while SOC patients received favipiravir and needed non-invasive or invasive ventilation more often. Main symptoms during COVID19 were similar, most patients reported fatigue, dyspnea and fever/chills. PASC symptom profile between the groups did not confirm differences, however in the RDV-group sleep disturbances disappeared in higher proportion and ≥50% reduction in symptoms was more common among RDV treated patients. PF and 6MWT parameters were similar, while patient reported QoL was significantly better in RDV-group. Patients treated with RDV spent less time in hospital and had more often at least 50% improvement in symptom profile at PASC indicating that this antiviral therapy might have a long-term beneficial effect on QoL.