Imperial College London
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Peter Openshaw - Professor of Experimental Medicine

Faculty of Medicine, National Heart & Lung Institute

Proconsul, Professor of Experimental Medicine
 
 
 
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Contact

 

+44 (0)20 7594 3854p.openshaw Website CV

 
 
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Assistant

 

Ms Gale Lewis +44 (0)20 7594 0944

 
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Location

 

353Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Grundmann:2023:10.1002/ana.26536,
author = {Grundmann, A and Wu, C-H and Hardwick, M and Baillie, JK and Openshaw, PJ and Semple, MG and Böhning, D and Pett, S and Michael, BD and Thomas, RH and Galea, I and ISARIC4C, investigators},
doi = {10.1002/ana.26536},
journal = {Annals of Neurology},
pages = {88--102},
title = {Fewer COVID-19 neurological complications with dexamethasone and remdesivir},
url = {http://dx.doi.org/10.1002/ana.26536},
volume = {93},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVE: To assess the impact of treatment with dexamethasone, remdesivir or both on neurological complications in acute COVID-19. METHODS: We used observational data from the International Severe Acute and emerging Respiratory Infection Consortium (ISARIC) WHO Clinical Characterisation Protocol UK (CCP-UK). Hospital inpatients aged ≥18 years with laboratory-confirmed SARS-CoV-2 infection admitted between 31 January 2020 and 29 June 2021 were included. Treatment allocation was non-blinded and performed by reporting clinicians. A propensity scoring methodology was used to minimize confounding. Treatment with remdesivir, dexamethasone or both was assessed against standard of care. The primary outcome was a neurological complication occurring at the point of death, discharge, or resolution of the COVID-19 clinical episode. RESULTS: Out of 89,297 hospital inpatients, 64,088 had severe COVID-19 and 25,209 had non-hypoxic COVID-19. Neurological complications developed in 4.8% and 4.5% respectively. In both groups, neurological complications associated with increased mortality, ICU admission, worse self-care on discharge and time to recovery. In severe COVID-19, treatment with dexamethasone (n=21,129), remdesivir (n=1,428) and both combined (n=10,846) associated with a lower frequency of neurological complications: OR=0.76 (95% CI=0.69-0.83), OR 0.69 (95% CI=0.51-0.90) and OR=0.54, (95% CI=0.47-0.61) respectively. In non-hypoxic COVID-19, dexamethasone (n=2,580) associated with less neurological complications (OR=0.78, 95% CI 0.62-0.97), while the dexamethasone/remdesivir combination (n=460) showed a similar trend (OR=0.63, 95% CI=0.31-1.15). INTERPRETATION: Treatment with dexamethasone, remdesivir or both in patients hospitalised with COVID-19 associated with a lower frequency of neurological complications in an additive manner, such that the greatest benefit was observed in patients who received both drugs together. This article is protected by copyright. All
AU  - Grundmann,A
AU  - Wu,C-H
AU  - Hardwick,M
AU  - Baillie,JK
AU  - Openshaw,PJ
AU  - Semple,MG
AU  - Böhning,D
AU  - Pett,S
AU  - Michael,BD
AU  - Thomas,RH
AU  - Galea,I
AU  - ISARIC4C,investigators
DO  - 10.1002/ana.26536
EP  - 102
PY  - 2023///
SN  - 0364-5134
SP  - 88
TI  - Fewer COVID-19 neurological complications with dexamethasone and remdesivir
T2  - Annals of Neurology
UR  - http://dx.doi.org/10.1002/ana.26536
UR  - https://www.ncbi.nlm.nih.gov/pubmed/36261315
UR  - https://onlinelibrary.wiley.com/doi/10.1002/ana.26536
UR  - http://hdl.handle.net/10044/1/100310
VL  - 93
ER  -
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