Clinical Outcomes of COPD Patients Hospitalized for SARS-Cov-2 Infection During the Omicron Era: Comparative Effectiveness of Initiating Remdesivir in Addition to Corticosteroids Versus Corticosteroids Alone

Patients with chronic obstructive pulmonary disease (COPD) are vulnerable to developing severe SARS-CoV-2 infection. This retrospective study evaluated the effectiveness of remdesivir (RDV) initiated with corticosteroids (CCS) versus CCS only in patients with COPD hospitalized for SARS-CoV-2 infection during the Omicron period from December 2021 to February 2024. The analysis used patient-level data from the large, geographically diverse, US hospital administrative billing PINC AI healthcare database. Inverse probability of treatment weighting was used to adjust for potential confounding and enable a scientifically robust comparative assessment of differences in outcomes between treatment groups. Initiation of RDV with CCS upon admission for SARS-CoV-2 infection was associated with a lower mortality risk at 14 and 28 days with an overall adjusted hazard ratio [95% CI] of 0.74 [0.68-0.80] and 0.76 [0.71-0.82], respectively, compared to initiation of CCS only. The combination of RDV and CCS was also associated with a lower mortality risk at 14 and 28 days for patients across baseline oxygen requirements compared to CCS only. These results highlight the benefit of timely RDV treatment in COPD patients hospitalized with SARS-CoV-2 infection and underscore the value of considering established treatment paradigms in the context of the most recent collective evidence.