Odd, this bigger study says it's not a statistically significant increase for the worst cases:
But Topol noted that there was no sign of a benefit in patients who began the study with the most severe baseline status — those who were on non-invasive ventilation, who were intubated on a ventilator, or who were receiving extracorporeal membrane oxygenation, a treatment in which the oxygen is added to the blood outside the body. “We need to get something that works for these patients who have a high mortality rate,” Topol said.
The study of 1,063 patients included 538 who received remdesivir and 521 who were given a placebo. Those who received remdesivir recovered in a median of 11 days, compared to 15 days for those who received placebo. Mortality in the remdesivir group was 7.1%, compared to 11.9% for the placebo group, but this difference was not statistically significant. This is slightly better than previously results.
The severity of patients’ illness was rated on a scale of 1 (not hospitalized) to 8 (dead). The lowest score in the study was a 4, denoting hospitalization, but no need for extra oxygen. The largest group of patients scored a 5, meaning they did need oxygen.
Among patients who scored a 4, there was a 38% benefit in the speed of recovery. Among those who scored 5, there was a 47% benefit. But that benefit fell to 20% among those who scored a 6, meaning they were receiving high-flow ventilation, and a decrease of 0.05% among those who scored a 7, meaning they were intubated or on extracorporeal membrane oxygenation. Until more data are available, doctors and researchers are likely to debate whether to use remdesivir in sicker patients.
There have been concerns that the study’s main goal, originally based on changes in the 8-point score at day 15, was changed before the result was analyzed. Changing goalposts can be a sign that researchers are skewing the results. In the paper, the researchers explain that the concern was that Covid-19 illness was persisting much longer than had been expected. But that original goal, the odds of improvement in the 8-point scale on day 15, was 50% higher in the remdesivir group, a highly statistically significant result.
Some critics saw flaws in the study that could affect how its results are interpreted. The study was stopped after a data safety and monitoring board, a panel of outside experts charged with safeguarding patients in the trial, notified the National Institute of Allergy and Infectious Diseases, which was running the study, that there had been a statistically significant benefit of remdesivir on mortality.
The New England Journal paper does not say, as is normally the case, that the study was stopped. As STAT reported two weeks ago, some critics believe that the study should have continued in order to better discern whether remdesivir reduces the death rate.
“It’s clear from the publication that the study was stopped prior to the completion of a significant number of patients,” said Steven Nissen, a cardiologist at the Cleveland Clinic. “By stopping it early the scientific community was deprived of the opportunity to determine whether remdesivir can or cannot reduce mortality.”
Yeah it seems like it doesnt do wonders if you give it, when the patient is already on a ventilor and near death.
Preferably as soon as their so bad their hospitalised, thats when you give it to them.
Necro-bump this 2020: http://gamrconnect.vgchartz.com/thread.php?id=229249
Bumb in 2021: http://gamrconnect.vgchartz.com/post.php?id=9047071