Effectiveness of Remdesivir on All‐Cause In‐Hospital Mortality in Patients With Chronic Respiratory Comorbidities Who Are Hospitalized With COVID‐19 in the United States

Chronic respiratory disease increases the risk of severe COVID-19. Remdesivir is a globally approved treatment for COVID-19. This study examined the relationship between early remdesivir and all-cause in-hospital mortality among patients with chronic respiratory comorbidities during the SARS-CoV-2 Omicron era in the United States. Chargemaster and claims data from the HealthVerity database were used in a retrospective comparative effectiveness study (December 2021-April 2025). Adults hospitalized with COVID-19 with ≥ 1 chronic respiratory comorbidity were included. Patients who received ≥ 1 dose of remdesivir in the first 2 days of hospitalization (early remdesivir) were compared with those who did not (comparator). Patient characteristics were balanced using coarsened exact matching and propensity score (PS) matching. Hazard ratios (HRs) and 95% CIs for 28-day all-cause in-hospital mortality were estimated using Cox proportional hazards models for the overall cohort and for the subgroups stratified by supplemental oxygen use. Overall, 40,817 patients were included in the analysis. In the overall matched cohort (n = 12,071 per group), early remdesivir was associated with a significant reduction in 28-day all-cause in-hospital mortality risk (PS-matched HR: 0.75 [95% CI: 0.67, 0.83]; p < 0.01). In the subgroup analysis, early remdesivir was associated with significant reductions in mortality risk in both patients who did not receive supplemental oxygen (PS-matched HR: 0.72 [95% CI: 0.57, 0.90]; p < 0.01) and those who did receive supplemental oxygen (PS-matched HR: 0.77 [95% CI: 0.69, 0.87]; p < 0.01). Early remdesivir is associated with improved survival among patients with chronic respiratory disease who are hospitalized with COVID-19.