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The Role of Multidimensional Prognostic Index to Identify Hospitalized Older Adults with COVID-19 Who Can Benefit from Remdesivir Treatment: An Observational, Prospective, Multicenter Study

2023Journal article Open access
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dc.contributor.authorCustodero, C
dc.contributor.authorVeronese, N
dc.contributor.authorTopinkova, E
dc.contributor.authorMichalkova, H
dc.contributor.authorPolidori, MC
dc.contributor.authorCella, A
dc.contributor.authorCruz-Jentoft, AJ
dc.contributor.authorvon Arnim, CAF
dc.contributor.authorAzzini, M
dc.contributor.authorGruner, H
dc.contributor.authorCastagna, A
dc.contributor.authorCenderello, G
dc.contributor.authorCustureri, R
dc.contributor.authorZieschang, T
dc.contributor.authorPadovani, A
dc.contributor.authorSanchez-Garcia, E
dc.contributor.authorPilotto, A
dc.contributor.authorBarbagallo, M
dc.contributor.authorDini, S
dc.contributor.authorDiesner, NM
dc.contributor.authorFernandes, M
dc.contributor.authorGandolfo, F
dc.contributor.authorGaraboldi, S
dc.contributor.authorMusacchio, C
dc.contributor.authorPilotto, A
dc.contributor.authorPickert, L
dc.contributor.authorPodestà, S
dc.contributor.authorRuotolo, G
dc.contributor.authorSciolè, K
dc.contributor.authorSchlotmann, J
dc.date.accessioned2024-03-20T12:27:43Z
dc.date.available2024-03-20T12:27:43Z
dc.date.issued2023
dc.description.abstractBackground: Data regarding the importance of multidimensional frailty to guide clinical decision making for remdesivir use in older patients with coronavirus disease 2019 (COVID-19) are largely unexplored. Objective: The aim of this research was to evaluate if the Multidimensional Prognostic Index (MPI), a multidimensional frailty tool based on the Comprehensive Geriatric Assessment (CGA), may help physicians in identifying older hospitalized patients affected by COVID-19 who might benefit from the use of remdesivir. Methods: This was a multicenter, prospective study of older adults hospitalized for COVID-19 in 10 European hospitals, followed-up for 90 days after hospital discharge. A standardized CGA was performed at hospital admission and the MPI was calculated, with a final score ranging between 0 (lowest mortality risk) and 1 (highest mortality risk). We assessed survival with Cox regression, and the impact of remdesivir on mortality (overall and in hospital) with propensity score analysis, stratified by MPI = 0.50. Results: Among 496 older adults hospitalized for COVID-19 (mean age 80 years, female 59.9%), 140 (28.2% of patients) were treated with remdesivir. During the 90 days of follow-up, 175 deaths were reported, 115 in hospital. Remdesivir treatment significantly reduced the risk of overall mortality (hazard ratio [HR] 0.54, 95% confidence interval CI 0.35-0.83 in the propensity score analysis) in the sample as whole. Stratifying the population, based on MPI score, the effect was observed only in less frail participants (HR 0.47, 95% CI 0.22-0.96 in propensity score analysis), but not in frailer subjects. In-hospital mortality was not influenced by remdesivir use. Conclusions: MPI could help to identify less frail older adults hospitalized for COVID-19 who could benefit more from remdesivir treatment in terms of long-term survival.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationDrugs Aging . 2023 Jul;40(7):643-651pt_PT
dc.identifier.doi10.1007/s40266-023-01036-2pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4853
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerlinkpt_PT
dc.subjectAgedpt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectCOVID-19 Drug Treatmentpt_PT
dc.subjectCOVID-19*pt_PT
dc.subjectFemalept_PT
dc.subjectFrailty* / drug therapypt_PT
dc.subjectGeriatric Assessment / methodspt_PT
dc.subjectHumanspt_PT
dc.subjectPrognosispt_PT
dc.subjectProspective Studiespt_PT
dc.subjectHCC MEDpt_PT
dc.titleThe Role of Multidimensional Prognostic Index to Identify Hospitalized Older Adults with COVID-19 Who Can Benefit from Remdesivir Treatment: An Observational, Prospective, Multicenter Studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage651pt_PT
oaire.citation.issue7pt_PT
oaire.citation.startPage643pt_PT
oaire.citation.titleDrugs & Agingpt_PT
oaire.citation.volume40pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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