Anticipating its use would ensure lower progression of the infection, greater recovery, fewer hospitalizations and admissions to intensive careRome, June 22, 2021 – It has been found that the use of specific antivirals for SARS-COV-2 infection (ed. Remdesivir) is more effective if carried out from the early stages of the onset of COVID-19 infection.
To date, antiviral therapy is only given in the hospital and in more advanced stages of the disease. Clinical evidence has shown that an early use of these drugs would lead to a reduction in the progression of the infection, a faster recovery speed, less recourse to hospitalization and therefore a reduction in intensive care admissions.
The availability of up-to-date hospital treatment protocols that ensure timeliness of treatment could help achieve this important public health goal. With the aim of investigating the issue together with clinicians, decision makers, health economists and scientific societies, Motori Sanità organized the webinar ‘ORGANIZATIONAL IMPACT OF THERAPIES FOR THE TREATMENT OF VIRAL COVID INFECTION’, created thanks to the unconditional contribution of GILEAD.
“The COVID pandemic has put a strain on the organization of the NHS both in the hospital and territorial components, in a” continuum “of diagnostic-therapeutic assistance but also of hygiene and prevention of further spread.
In a context of rapid change in epidemiology, pathomorphosis and ventilator support needs of mostly elderly and comorbid patients, an interdisciplinary collaboration was required for which the consultant infectious disease specialists were ready and solicited by years of recent programs and contexts of antimicrobial stewardship.
The rapid relocation, also thanks to the international literature, of medicaments that at first seemed promising, has made it possible to vary the primary therapeutic support up to the proposal of the guidelines now available, such as those of the SITA (Italian Society of Anti-infectious Therapy) ,
SIMIT and international. Beyond the therapeutic aspect, of exquisite infectious competence, it is also important to discuss the practical managerial-structural-organizational aspect of the in-hospital care and support paths, whether they are internist doctors, emergency medicine, pneumology, intensive care, endocrinology or
Nursing and Health Management “, said Francesco G. De Rosa, Associate Professor of Infectious Diseases SC Infectious Diseases U AOU City of Health and Science, Turin and Cardinal Massaia Hospital, Asti
“The estimation of the capabilities of intensive care starts from a dynamic epidemiological model thanks to which it is possible to simulate the evolution of the pandemic course. This simulation is based on assumptions relating to changes in the reproduction rate RT which takes into account the developments of the vaccination campaign and policies regarding social distancing.
The simulation returns a number of infected people, a portion of whom, on the basis of literature data and observable empirically, are hospitalized in the ordinary regime or in intensive care.
This second phase of the model is based on a Markov chain that simulates the therapeutic path of the hospitalized and therefore allows to calculate for each week of observation, the number of intensive care units occupied, the number of deaths and the relative hospital costs. The data relating to the effectiveness of Remdesivir and also the average length of hospital stays in both ordinary and intensive care were then applied to this simulation.
This made it possible to compare both the clinical and economic effects deriving from the use of Remdesivir in eligible subjects. The results show how the use of this therapy would allow, over 20 weeks, to save about 13,000 lives, occupy a total of about 9,000 fewer intensive therapies (over the entire 20 weeks) and to obtain savings of 400 million euros. .
It should be remembered how the model can be adapted to further changes during the pandemic, with the primary aim of informing decision makers about the potential value deriving from the introduction of therapeutic strategies aimed at decreasing the pressure on intensive care and the rate of mortality ”, explained Matteo Ruggeri, Researcher, National Center of HTA – Higher Institute of Health and Professor of Economic Policy, St Camillus International University of Health Sciences, Rome.