Association of Treatment with Remdesivir and 30-day Hospital Readmissions in Patients Hospitalized with COVID-19

Background: Since the beginning of COVID-19 pandemic, there has been a widespread use of remdesivir in adults and children. There is little known information about remdesivir's role in reducing 30-day readmissions after hospitalization with COVID-19. This study aimed to determine whether treatment with remdesivir was associated with reduced risk of 30-day readmission after index hospitalization with COVID-19.

Methods: The study was a multi-center cohort study in Rhode Island, USA. Patients included all adults that were discharged after hospital treatment for COVID-19 between April 1 and December 31, 2020. The main study outcomes were length of hospital stay, 30-day readmission, and post-discharge 30 days mortality.

Results: A total of 2,062 patients (2,279 hospitalizations) were included in the analytic sample. Patients were less likely to be readmitted within 30 days if they received remdesivir relative to not receiving remdesivir; associations were strongest for those with mild disease (RR: 0.31; 95% CI: 0.13,0.75). Remdesivir treatment was associated with reduction in all-cause mortality (HR: 0.65; 95% CI: 0.49,0.85) and an increase in length of stay (estimated average increase of 3.27 days; 95% CI: 2.11,4.44).

Limitation: Unmeasured factors such as time-to-treatment and severity of disease prior to initiation of remdesivir.

Conclusions: Remdesivir may be an effective strategy for reducing progression to severe COVID-19 disease and limiting morbidity associated with readmission to hospital. Larger prospective studies are justified to study the role of remdesivir in mild or early COVID-19 with high risk of disease progression and readmission to hospital within 30 days.