Effect of remdesivir on patients with COVID-19: A network meta-analysis of randomized control trials

Virus Res. 2020 Oct 15:288:198137. doi: 10.1016/j.virusres.2020.198137. Epub 2020 Aug 19.

Abstract

Several randomized controlled trials (RCTs) were conducted to investigate the effect of remdesivir for patients with COVID-19, but their results were conflicting. Thus, we conducted a network meta-analysis comparing the rate of clinical improvement among patients with COVID-19 who received 5-day course of remdesivir versus 10-day course of remdesivir versus standard care. Our network meta-analysis of 4 randomized controlled trials demonstrated that the rate of clinical improvement was significantly higher in the 5-day remdesivir group and 10-day remdesivir group compared to standard care group (OR [95% confidence interval [CI]] =1.89 [1.40-2.56], P <0.001, OR [95% CI] =1.38 [1.15-1.66], P <0.001, respectively). In addition, the rate of clinical improvement was significantly higher in the 5-day remdesivir group compared to the 10-day remdesivir group (OR [95% confidence interval [CI]] =1.37 [1.01-1.85], P =0.041). Our analysis demonstrated that the use of remdesivir for patients with COVID-19 was associated with the significantly higher clinical improvement rate compared with standard care alone.

Keywords: COVID-19; Remdesivir.

Publication types

  • Meta-Analysis

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives*
  • Adenosine Monophosphate / therapeutic use
  • Alanine / analogs & derivatives*
  • Alanine / therapeutic use
  • Antimetabolites / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • Betacoronavirus / drug effects*
  • Betacoronavirus / growth & development
  • Betacoronavirus / metabolism
  • COVID-19
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / mortality
  • Coronavirus Infections / virology
  • Disease Progression
  • Drug Administration Schedule
  • Humans
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / virology
  • Randomized Controlled Trials as Topic
  • SARS-CoV-2
  • Severity of Illness Index
  • Survival Analysis
  • Treatment Outcome

Substances

  • Antimetabolites
  • Antiviral Agents
  • remdesivir
  • Adenosine Monophosphate
  • Alanine