Hospital at Home treatment with Remdesivir for patients with COVID-19: Real life experience

Background : Access and appropriateness of therapeutics for COVID-19 vary due to access or regulatory barriers, severity of disease, and for some therapies, stage of the pandemic and circulating variants. Remdesivir has shown benefits in clinical recovery and is the treatment of choice for selected patients, both hospitalized and non-hospitalized, in main international guidelines. The use of Remdesivir in alternatives to conventional hospitalization such as Hospital at Home units remain incompletely explored. In this work, we aim to describe the real-life experience of outpatient remdesivir infusion for COVID-19 in a Hospital at Home unit. Methods : We selected all the consecutive patients receiving remdesivir from a prospective cohort of 507 COVID-19 patients admitted at a Hospital at Home unit. Admission criteria included COVID-19 with FiO2 requirement under 0.35 and respiratory rate under 22 rpm. Patients were daily assessed in-person by a nurse and a physician. Results : Two-hundred thirty-six patients admitted in HaH received remdesivir, from whom 172 were treated at home. Only 2% presented any adverse event related to the infusion, all of them mild. HaH saved 1416 day-beds, with only 5% of the patients requiring transfer back to hospital. Conclusions : Remdesivir infusion in Hospital at Home units seems to be a safe and efficient alternative to conventional hospitalization for treating non-severe COVID-19 patients.