Remdesivir Therapy in Patients with COVID-19: A Systematic Review and Meta-analysis of Randomized Controlled Trials

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],  < 0.001). The odds of early (at day 14/15; OR = 1.42 [95% CI: 1.16; 1.74],  < 0.001) and late (at day 28/29; OR = 1.44 [95% CI: 1.16; 1.79],  = 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],  = 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.