Patient characteristics, treatment patterns, and clinical outcomes of remdesivir in hospitalized COVID-19 patients with diabetes mellitus on insulin: A large-scale data analysis using a Japanese claims database

• We described treatment pattern and clinical outcomes of hospitalized COVID-19 patients with diabetes on insulin in Japan • We used anonymized data of RDV treated patients from Medical Data Vision, Co., Ltd. • Most patients were elderly and required oxygen support at RDV initiation • Majority patients received RDV in 3 days of hospitalization and recovered by 28 days To describe treatment patterns and clinical outcomes in Japanese patients with diabetes mellitus (DM) hospitalized for coronavirus disease-2019 (COVID-19) treated with remdesivir (RDV). We included data from patients aged ≥ 18 years with DM on insulin, hospitalized for moderate to severe COVID-19, and who received ≥ 1 dose of RDV between October 2021 and September 2022, using a Japanese medical claims database. All-cause mortality, progression to severe COVID-19, and hospital discharge/recovery status were evaluated up to 56 days from the index date defined as RDV initiation. The analysis included 502 patients. The mean (SD) age at index was 74.4 (12.5) years. Median (Q1–Q3) time to RDV initiation was 2.0 (1.0–3.0) days from hospital admission; median treatment duration was 5.0 (3.0–5.0) days. At index date, 36.85% of patients had moderate I disease (hospitalized without oxygen support), 58.96% had moderate II disease (non-invasive positive pressure ventilation, low/high-flow oxygen), and 4.18% had severe disease (ICU admission, mechanical ventilation, or extracorporeal membrane oxygenation). Proportion of patients with all-cause mortality was 11.16% (95% CI, 8.54–14.24) and 13.15% (10.32–16.42) by 28 and 56 days. At 28 days, 12.35% (9.60–15.55) of patients had disease progression, and 68.13% (63.85–72.19) had recovery. Most patients were elderly and required oxygen support when initiating RDV. The majority of patients received RDV within 3 days of hospitalization and recovered by 28 days. The study provides insight into outcomes in Japanese COVID-19 patients with DM treated with RDV in inpatient settings.