Intravenous Administration of Remdesivir at the Acute Phase of SARS-CoV-2 Infection Is Associated with a Lower Prevalence of Post-COVID-19 Pain.

Background/

Objective

Evidence suggests that the administration of antivirals at the acute phase of SARS-CoV-2 infection is associated with lower COVID-19 severity, accordingly, the administration of antivirals at the acute phase of the infection could prevent post-COVID-19 symptoms. The current study investigated the effects of the intravenous administration of Remdesivir at hospitalization (acute phase of SARS-CoV-2 infection) in COVID-19 survivors on the development of post-COVID-19 pain symptoms.

Methods

A cohort of previously hospitalized COVID-19 survivors who received intravenous administration of Remdesivir at the acute COVID-19 phase (n = 216) were matched with a cohort of previously hospitalized COVID-19 survivors who did not receive any antiviral treatment at the acute phase of the infection (n = 216). In a face-to-face interview, they were asked for the development of pain symptoms attributed to SARS-CoV-2 infection and whether the symptom persisted at the time of the study (mean follow-up: 18.4, SD: 0.8 months). Clinical/hospitalization data were collected from medical records. Anxiety/depressive symptoms and sleep quality were also assessed with validated self-reported questionnaires.

Results

No differences in hospitalization data and the presence of previous chronic conditions were seen between patients receiving or not receiving intravenous administration of Remdesivir during hospitalization. The multivariate analysis revealed that the intravenous administration of Remdesivir at the acute COVID-19 phase was a protective factor for the development of overall post-COVID-19 pain (OR 0.444, 95% CI 0.292-0.674, p < 0.001). A protective effect of administrating intravenous Remdesivir was specifically seen for thorax/chest (OR 0.277, 95% CI 0.100-0.766, p = 0.01) and lumbar spine (OR 0.347, 95% CI 0.143-0.844, p = 0.02) pain.

Conclusions

Current results support a potential protective role of the intravenous administration of Remdesivir at the acute phase of SARS-CoV-2 infection for developing long-term post-COVID-19 pain in previously hospitalized COVID-19 survivors. Studies investigating the effects of the oral administration of antivirals in non-hospitalized populations are needed to generalize these findings.