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. 2021 Jan 27:7:606429.
doi: 10.3389/fmed.2020.606429. eCollection 2020.

Mortality Benefit of Remdesivir in COVID-19: A Systematic Review and Meta-Analysis

Vikas Bansal  1 , Kiran S Mahapure  2 , Abhishek Bhurwal  3 , Ishita Gupta  4 , Sahar Hassanain  5 , Janaki Makadia  6 , Nimisha Madas  7 , Paige Armaly  8 , Romil Singh  9 , Ishita Mehra  10   11 , John C O'Horo  12 , Rahul Kashyap  1
Affiliations

Mortality Benefit of Remdesivir in COVID-19: A Systematic Review and Meta-Analysis

Vikas Bansal et al. Front Med (Lausanne). .

Abstract

Importance/Background: During current public health emergency of COVID-19 pandemic, repurposing of existing antiviral drugs may be an efficient strategy since there is no proven effective treatment. Published literature shows Remdesivir has broad-spectrum antiviral activity against numerous RNA viruses and has been recently recognized as a promising therapy against SARS-CoV-2. Methods: A systematic search was conducted for full length manuscripts published between inception and July 19th, 2020 focussing on efficacy and safety of Remdesivir in COVID-19. The primary outcomes were defined as mortality rate and median days to recovery based on the available pooled data. The secondary outcome was adverse events rate and drug discontinuation rate. Statistical Analysis: All outcomes were performed using Comprehensive Meta-Analysis software package (Bio stat, Englewood, NJ, USA). Results: A total of 1,895 patients from 9 studies were included in this qualitative synthesis. In patients treated with Remdesivir, the mean recovery time was 15.84 days (95% CI 11.68-20, SE 2.12; I 2 = 97.24) and the pooled mortality rate was 11.3% (95% CI 7.9-16%; I 2 = 74.85). However, treatment with Remdesivir was associated with adverse effects (55.3%, 95% CI 31.5-76.9%; I 2 = 97.66) eventually warranting the discontinuation of the drug (17.8%, 95% CI 8.6-33.1%; I 2 = 95.64). The meta-analysis of three clinical trials indicated that administration of Remdesivir significantly reduces the mortality compared to the placebo (OR 0.70, 95% CI 0.58-0.84, p ≤ 0.001; I 2 = 16.6). Conclusions and Relevance: The result of contemporary meta-analysis suggests mortality benefit with Remdesivir in COVID-19 and median recovery time was over 2 weeks. The pooled mortality with Remdesivir was found to be very low, and this analysis can shed light on this potential treatment for COVID-19 patients.

Keywords: COVID-19; Remdesivir (GS-5734); SARS-CoV-2; meta-analysis; mortality; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA study flow diagram.
Figure 2
Figure 2
Remdesivir and mortality outcome.
See this image and copyright information in PMC

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