الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
T
he newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was initially reported on December 2019 (2019-nCOV) in the city Wuhan; Hubei province, China. The first COVID-19 case in Egypt was reported on the 14th of February 2020.
Most of COVID-19 patients present with common symptoms including fever, cough, myalgia and fatigue at the onset. The majority of patients recover, however, some patients will progress into severe complications including acute respiratory distress syndrome (ARDS), which may worsen rapidly into respiratory failure, need an intensive care unit (ICU), and even cause multiple organ failure.
The aim of the study is to evaluate the clinical outcome of using remdesivir in elderly patients with severe and critically ill COVID-19 infection who have received standard of care and remdesivir in comparison with similar patients who have received standard of care only.
This study is a retrospective observational study conducted at Geriatric Hospital for isolation of COVID- 19 patients at Ain Shams University. A 330 severe or critically ill patients with acute respiratory syndrome covid virus 2 (SARS-CoV2) infection diagnosed by PCR from nasopharyngeal swab. Patients are 60 years and older. They were classified into 2 groups: group A: 165 patients who received standard of care treatment plus remdesivir, group B: 165 patients who received standard of care treatment only.
Our study showed that Taking remdesivir, absence of anemia lead to decrease probability of complications while severe and critically ill cases are independent risk factors for developing complications with significant difference statistically.
In our study Cox regression analysis for factors affecting overall survival shows taking remdesivir, older age, absence of anemia lead to significant survival benefit.
Also our study showed that Length of hospital stay in cases who received remdesivir was more than cases who didn’t receive it with no significant difference statistically and the Percentage of cases discharged on oxygen is less in cases who didn’t receive remdesivir, this could be due to that the percentage of mortality was higher among cases who did not receive remdesivir than cases who received it.
The current study showed that the percentage of acute respiratory distress syndrome (ARDS) was significantly lower in cases who receive remdesivir, also their mean survival time more than those who didn’t receive it with significant difference statistically, also older age, not taking remdesivir and development of complications are independent risk factors for mortality that lead to one of our important result that in hospital mortality was less in cases who received remdesivir with significant difference statistically and that clarify the advantage of using remdesivir.
CONCLUSION
O
ur data revealed that treatment with RDV within 12 days of symptoms had an effect on elderly patient outcomes over standard care treatment, including ARDS and the need for MV, and inhospital mortality.
RECOMMENDATIONS
1. We recommend using remdesivir as it was well tolerated for elderly and decreased mortality
2. Using remdesivir is recommended in eldery within 12 days of onset of symptoms.
3. Following preventive measures of Covid-19 infection to decrease spread of the disease and mortality.
4. Vaccination against covid 19 as it decrease severity of the disease and complications.
5. Multicenter studies with larger sample size are needed to support our results for better outcome.
6. More studies with different standards of care treatment and other antivirals.
7. More studies with better randomization of study group.