Outcomes Among Patients Hospitalized for COVID-19 Treated with Remdesivir in an Urban Center Pre-COVID-19 Vaccination

OBJECTIVE

Data on treatment outcomes among minority populations treated with remdesivir are limited. We sought to evaluate outcomes among patients hospitalized with COVID-19 and treated with remdesivir among a predominantly Black and LatinX population.

METHODS

This was a retrospective cohort study of adult patients hospitalized with COVID-19 and treated with remdesivir at an urban hospital in Newark, NJ, between May 1, 2020, and April 30, 2021, prior to widespread COVID-19 vaccination uptake. We describe 28-day mortality by demographic, socio-economic, and clinical factors, including clinical status by World Health Organization's (WHO) 8-point Ordinal Scale for Clinical Improvement.

RESULTS

A total of 206 patients met study inclusion criteria (52% were male, 41% non-Hispanic Black and 42% Hispanic). Overall mortality at 28 days was 11%. Eighty-one percent of patients with baseline WHO status of 4 or greater recovered by day 14. Mortality was higher among those who were older (p = 0.01), those with underlying diabetes mellitus (p = 0.047), those with more severe illness on admission by WHO Ordinal Scale (WHO status ≥ 4), and those on concomitant tociluzimab or convalescent plasma use.

CONCLUSIONS

We found that remdesivir was effective in treating most COVID-19 patients in our study. Traditional risk factors, such as advanced age and underlying co-morbidities, were associated with worse clinical outcomes and deaths.

Ablation, Melting, and Smoothing of Polycrystalline Alumina by Pulsed Excimer Laser Radiation

The effects of pulsed XeCl (308 nm) laser radiation on polycrystalline Al2O3 (alumina, 99.6% pure) and single-crystal Al2O3 (sapphire) are studied as a function of laser fluence. No laser etching ofeither material is detected below a threshold fluence value, which is much lower for alumina than for sapphire. Above this threshold, laser etching of both materials is observed following a number of incubation (induction) pulses. This number is much larger for sapphire than for alumina but decreases with increasing fluence for both materials. Laser etching rates for the two materials are similar at high fluences and after the incubation period. Scanning electron microscope images show that alumina melts and flows under repeated irradiation at fluences ≥0.7 J/cm2. Atomic force microscopy and surface profilometry reveal significant smoothing of the as-received polycrystalline alumina surface after repeated irradiations at moderate fluences (∼1−3 J/cm2). Ion probe measurements for alumina in vacuum confirm the incubation behavior, and reveal that at fixed fluence the (positive) charge collected per pulse saturates after a sufficient number of pulses, as does the etch-plume velocity. The results are interpreted in terms of laser-generation of a sufficient concentration of absorption centers before efficient ablation/etching of these wide bandgap materials can occur.