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

TL;DR

Giving Remdesivir intravenously during early SARS-CoV-2 infection may reduce the risk of long-term pain in hospitalized COVID-19 survivors.

Contribution

This study shows that early intravenous Remdesivir treatment is linked to lower post-COVID-19 pain prevalence.

Findings

Intravenous Remdesivir during acute infection reduced overall post-COVID-19 pain (OR 0.444).

Remdesivir was specifically protective for thorax/chest and lumbar spine pain.

No differences in baseline health or hospitalization data were observed between groups.

Abstract

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.

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