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Review
. 2021 Jan 6:62:43-48.
doi: 10.1016/j.amsu.2020.12.051. eCollection 2021 Feb.

Remdesivir therapy in patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials

Charan Thej Reddy Vegivinti  1 , John M Pederson  2 , Kavitha Saravu  3 , Nitin Gupta  3 , Averi Barrett  2 , Amber R Davis  4 , Kevin M Kallmes  2 , Kirk W Evanson  4
Affiliations
Review

Remdesivir therapy in patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials

Charan Thej Reddy Vegivinti et al. Ann Med Surg (Lond). .

Abstract

Purpose: To perform a systematic review and meta-analysis of randomized controlled trials that examined remdesivir treatment for COVID-19.

Materials and methods: A systematic literature search was performed using Pubmed, Embase, and ClinicalTrials.gov to identify studies published up to October 25, 2020 that examined COVID-19 treatment with remdesivir. A total of 3 randomized controlled trials that consisted of 1691 patients were included in the meta-analysis.

Results: The odds for mechanical ventilation (MV) or extracorporeal membrane oxygenation (ECMO) following treatment was significantly lower in the remdesivir group compared to the control group (OR = 0.48 [95% CI: 0.34; 0.69], p < 0.001). The odds of early (at day 14/15; OR = 1.42 [95% CI: 1.16; 1.74], p < 0.001) and late (at day 28/29; OR = 1.44 [95% CI: 1.16; 1.79], p = 0.001) hospital discharge were significantly higher in the remdesivir group compared to the control group. There was no difference in the odds for mortality in patients treated with remdesivir (OR = 0.77 [95% CI: 0.56; 1.06], p = 0.108).

Conclusions: Remdesivir attenuates disease progression, leading to lower odds of MV/ECMO and greater odds of hospital discharge for COVID-19 patients. However, remdesivir does not affect odds of mortality.

Keywords: Antiviral agents; Coronavirus; SARS virus; Therapeutic uses.

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Conflict of interest statement

The authors declare no interests with the subject of this manuscript. J.M.P. is employed by Nested Knowledge, Superior Medical Experts, and Marblehead Medical. K.M.K. works for and holds equity in Nested Knowledge, Superior Medical Experts, and Marblehead Medical. A.R.D. and K.W.E. are employed by Superior Medical Experts.

Figures

Fig. 1
Fig. 1
PRISMA diagram of search records and included studies.
Fig. 2
Fig. 2
Forest plot of subgroup comparisons of need for mechanical ventilation or ECMO at 28/29 days. Pooled results were computed using restricted effects maximum likelihood with 95% confidence intervals computed using the Q-profile method. A 95% prediction interval was also computed (black bar).
Fig. 3
Fig. 3
Forest plot of subgroup comparisons of hospital discharge at 14/15 days. Pooled results were computed using restricted effects maximum likelihood with 95% confidence intervals computed using the Q-profile method. A 95% prediction interval was also computed (black bar).
Fig. 4
Fig. 4
Forest plot of subgroup comparisons of hospital discharge at 28/29 days. Pooled results were computed using restricted effects maximum likelihood with 95% confidence intervals computed using the Q-profile method. A 95% prediction interval was also computed (black bar).
Fig. 5
Fig. 5
Forest plot of subgroup comparisons of mortality at 28/29 days. Pooled results were computed using restricted effects maximum likelihood with 95% confidence intervals computed using the Q-profile method. A 95% prediction interval was also computed (black bar).
See this image and copyright information in PMC

References

    1. Coronavirus disease COVID-19 Weekly epidemiological update and weekly operational update. 2020. https://www.who.int/publications/m/item/weekly-operational-update-on-cov... 7 December 2020.
    1. Richardson S., Hirsch J.S., Narasimhan M., Crawford J.M., McGinn T., Davidson K.W., Northwell the, Barnaby D.P., Becker L.B., Chelico J.D., Cohen S.L., Cookingham J., Coppa K., Diefenbach M.A., Dominello A.J., Duer-Hefele J., Falzon L., Gitlin J., Hajizadeh N., Harvin T.G., Hirschwerk D.A., Kim E.J., Kozel Z.M., Marrast L.M., Mogavero J.N., Osorio G.A., Qiu M., Zanos T.P. JAMA; 2020. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized with COVID-19 in the New York City Area. - PMC - PubMed
    1. Guan W.J., Liang W.H., Zhao Y., Liang H.R., Chen Z.S., Li Y.M., Liu X.Q., Chen R.C., Tang C.L., Wang T., Ou C.Q., Li L., Chen P.Y., Sang L., Wang W., Li J.F., Li C.C., Ou L.M., Cheng B., Xiong S., Ni Z.Y., Xiang J., Hu Y., Liu L., Shan H., Lei C.L., Peng Y.X., Wei L., Liu Y., Hu Y.H., Peng P., Wang J.M., Liu J.Y., Chen Z., Li G., Zheng Z.J., Qiu S.Q., Luo J., Ye C.J., Zhu S.Y., Cheng L.L., Ye F., Li S.Y., Zheng J.P., Zhang N.F., Zhong N.S., He J.X. C. China medical treatment expert group for, comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur. Respir. J. 2020;55(5) - PMC - PubMed
    1. Yang J., Zheng Y., Gou X., Pu K., Chen Z., Guo Q., Ji R., Wang H., Wang Y., Zhou Y. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int. J. Infect. Dis. 2020;94:91–95. - PMC - PubMed
    1. Gordon C.J., Tchesnokov E.P., Woolner E., Perry J.K., Feng J.Y., Porter D.P., Gotte M. Remdesivir is a direct-acting antiviral that inhibits RNA-dependent RNA polymerase from severe acute respiratory syndrome coronavirus 2 with high potency. J. Biol. Chem. 2020;295(20):6785–6797. - PMC - PubMed