Predictors of response to remdesivir in GS-5773 COVID-19 study
Simon Collins, HIV i-Base
Kristen Marks, from Weill Cornell Medicine presented results on predictors of response from patients in a substudy of GS-5773, comparing 5 vs 10-days of remdesivir in severe COVID-19. In practice, participants used remdesivir for a range of days in each arm and because the 5-day arms was as effective as 10-days, results from both arms were combined in this analysis. 
The 5773 study enrolled 397 participants, at 55 sites in 8 countries, most from the US (n=229), Italy (n=77) and Spain (n=61).
Endpoints included time to clinical improvement and all-cause mortality, both at day 14.
Baseline characteristics included 168 (42%) ≥65 years old, 144 (36%) female, 276 (70%) white, 45 (11%) Asian, and 44 (11%) Black. Overall, 122 patients (31%) were on high-grade oxygen support (including invasive mechanical ventilation (3%) and non-invasive positive pressure ventilation or high-flow nasal cannula (27%), with 220 (55%) on low-grade oxygen support. Comorbidities were reported as common (50% hypertension, 22% diabetes) and median BMI was 28.7 kg/m2 (range: 16 to 63).
After median follow-up of 10 days (range: 1 to 33 days), 256/397 patients had ≥2-point improvement in the 7-point ordinal scale (from 1=death to 7= not hospitalised) and 44 died.
In a multivariable analysis, baseline factors significantly positively associated with ≥2-point clinical improvement or mortality are included in Table 1. Treatment duration (5 vs 10 days) was not significant for either endpoint.
Racial differences were also included in a poster at the conference. 
Table 1: Baseline characteristics associated with clinical outcomes
|Baseline factors in multivariate analysis||HR
|Factors with >2 point improvemen|
|Lower grade respiratory support (low-flow oxygen or room air)||2.16
(1.50 to 3.10)
(1.46 to 2.55)
|Black race vs Asian||3.80
(2.28 to 6.35)
|White vs Asian||2.45
(1.60 to 3.76)
|Outside Italy (likely linked to time period of enrolment)||1.59
(1.07 to 2.37)
|No concomitant biologic medication use (ie IL-6, IFN etc)||2.70
(1.49 to 4.88)
|Factors associated with increased risk all-cause mortality|
|High-grade oxygen support||5.47
(2.74 to 10.90)
|history of COPD||3.41
(1.30 to 8.94)
(1.18 to 4.47)
- Marks K et al. Baseline characteristics associated with clinical improvement and mortality in hospitalized patients with severe COVID-19 treated with remdesivir. Track B, Oral abstract.
- HA not funny et al. Yes, try finding anything on the website. Many posters are listed for remdesivir but they might as well be written with magic dust.