In the largest single country trial of the potential COVID-19 treatment remdesivir to date, researchers have found the drug reduced the need for mechanical ventilation in hospitalized patients, when compared with standard of care.
The CATCO study, led by BC Children's Hospital investigator Dr. Srinivas Murthy, is a Canadian Institutes of Health Research funded substudy of the large global World Health Organization Solidarity trial which is examining various treatments for COVID-19. In the CATCO trial, which involved 52 Canadian hospitals, researchers studied the effect of remdesivir in more than 1,200 hospitalized patients with COVID-19 between August 14, 2020 and April 1, 2021. About half the patients were randomly assigned to receive remdesivir, a repurposed antiviral medication. To date, evidence has been mixed on the effect of the drug in people with COVID-19.
The CATCO trial found that patients who were not ventilated at the start of the study and given remdesivir had a lower chance of needing ventilation during their hospital stay - eight per cent vs. 15 per cent in the group receiving standard treatment. The patients on remdesivir who did require breathing support were also able to come off oxygen and mechanical ventilation sooner - 15.9 compared to 14.2 days in the standard treatment group for oxygen, and 21.4 vs 19.5 for ventilation.
“The benefit of treatment was most apparent for preventing the need for mechanical ventilation, suggesting probable added value for patients with less severe disease to avoid progression during hospital stay,” said Dr. Murthy.
“This may have important implications for patients and for health systems, particularly when ICU capacity, mechanical ventilation or oxygen are in limited supply.”
The CATCO trial collected more detailed data compared with some other countries, and engaged patients across a range of ethnicities — particularly important for applications in other countries and in our multicultural society.
These results add to the larger global trial studying how remdesivir could be used in other countries.
“The findings of CATCO are also important and complementary to Solidarity as they help to address questions of generalizability of a large simple protocol carried out across a wide range of hospitals and health care systems from low-, middle- and high-income countries,” the authors conclude.
Credit: CMAJ News release
"Remdesivir for the treatment of patients in hospital with COVID-19 in Canada: a randomized controlled trial” is published January 19, 2022.