Alonso Navarro, RodrigoRamírez, MargaritaMasiá, MarParedes, RogerMontejano, RocíoPovar Echeverria, MarinaCarratalà, JordiSalavert, MiguelBernal, EnriqueDueñas, CarlosFlores, JuanFanjul, FranciscoGutiérrez, IsabelRico, VerónicaMateu, LourdesCadiñanos, JulenBerenguer Berenguer, JuanSoriano, Alex2025-12-122025-12-122023-05-041471-2334https://hdl.handle.net/2445/224863Background Shorter duration of symptoms before remdesivir has been associated with better outcomes. Our goal was to evaluate variables associated with the need of ICU admission in a cohort of hospitalized patients for COVID-19 under remdesivir including the period from symptoms onset to remdesivir. Methods We conducted a retrospective multicentric study analysing all patients admitted with COVID-19 in 9 Spanish hospitals who received treatment with remdesivir in October 2020. The main outcome was the need of ICU admission after 24 h of the first dose of remdesivir. Results In our cohort of 497 patients, the median of days from symptom onset to remdesivir was 5 days, and 70 of them (14.1%) were later admitted into ICU. The clinical outcomes associated with ICU admission were days from symptoms onset (5 vs. 6; p = 0.023), clinical signs of severe disease (respiratory rate, neutrophil count, ferritin levels and very-high mortality rate in SEIMC-Score) and the use of corticosteroids and anti-inflammatory drugs before ICU. The only variable significatively associated with risk reduction in the Cox-regression analyses was ≤ 5 days from symptoms onset to RDV (HR: 0.54, CI95%: 0.31–0.92; p = 0.024). Conclusion For patients admitted to the hospital with COVID-19, the prescription of remdesivir within 5 days from symptoms onset diminishes the need of ICU admission.7 p.application/pdfengcc-by (c) Alonso-Navarro Rodrigo et al., 2023http://creativecommons.org/licenses/by/4.0/Medicaments antivíricsCOVID-19Antiviral agentsCOVID-19info:eu-repo/semantics/article7545332025-12-12info:eu-repo/semantics/openAccess37142994