P-2039. Prognostic factors of disease progression in patients with mild-to-moderate COVID-19 on early remdesivir treatment in Taiwan

Abstract Background An early 3-day course of remdesivir treatment was recommended for high risk patients with mild-to-moderate COVID-19. We investigated the prognostic factors of disease progression and mortality in patients with mild-to-moderate COVID-19 who were treated with a 3-day course of remdesivir in Taiwan. Methods Adult patients with mild-to-moderate COVID-19 treated with a 3-day course of remdesivir at Taipei Veterans General Hospital from April–July 2022 were identified. The main outcomes were 14-day disease progression (defined as increased oxygen requirement compared with the baseline condition or mortality) and 28-day mortality. Logistic regression was used to identify independent variables associated with poor outcomes. Results Among the 345 patients on early remdesivir treatment with a 3-day course, 62 patients (18%) had 14-day disease progression, and 5 patients (1.4%) died within 28 days. Eighty patients (23.2%) did not receive COVID-19 vaccine before the diagnosis of COVID-19. Body mass index, cardiovascular disease, Charlson Comorbidity Index, and secondary bacterial infection were independent factors associated with 14-day disease progression, and nosocomial COVID-19 was the only independent factor associated with 28-day mortality. In 233 patients (67.5%) administered at least two doses of COVID-19 vaccine, 38 patients (16.3%) had 14-day disease progression, and 4 patients (1.7%) died within 28 days. Female sex, cardiovascular disease, and secondary bacterial infection were independent factors for 14-day disease progression. Nosocomial COVID-19 and C-reactive protein levels >10 mg/dL were independent factors associated with 28-day mortality. Conclusion Nosocomial COVID-19 and secondary bacterial infections predisposed these patients to poor outcomes, regardless of vaccination. Therefore, infection control measures are important in the fight against COVID-19. Disclosures All Authors: No reported disclosures