Dataset Information

Efficacy and safety of remdesivir in COVID-19 caused by SARS-CoV-2: a systematic review and meta-analysis.

ABSTRACT:

Objectives

Evaluation of remdesivir, an RNA polymerase inhibitor, for effectiveness in adults with COVID-19.

Data sources

Electronic search for eligible articles of PubMed, Cochrane Central and clinicaltrials.gov was performed on 20 September 2020.

Participants and study eligibility criteria

Only randomised controlled trials (RCTs) evaluating efficacy of remdesivir in COVID-19 were included for meta-analysis.

Interventions

Remdesivir was compared with standard of care.

Primary and secondary outcomes

Primary outcome was mortality and secondary outcomes were time to clinical improvement and safety outcomes like serious adverse events, respiratory failure.

Study appraisal and synthesis methods

Data synthesis was done with Cochrane review manager 5 (RevMan) V.5.3. Cochrane risk of bias V.2.0 tool was used for methodological quality assessment. The GRADE pro GDT was applied for overall quality of evidence.

Results

52 RCTs were screened and 4 studies were included in analysis, with total of 7324 patients. No mortality benefit was observed with remdesivir versus control group (OR=0.92 (95% CI 0.79 to 1.07), p=0.30, moderate quality evidence). Significantly higher rates of clinical improvement (OR=1.52 (95% CI 1.24 to 1.87), p<0.0001, low quality) and faster time to clinical improvement (HR=1.28 (95% CI 1.12 to 1.46), p=0.0002, very low quality) was observed with remdesivir versus control group. Significant decrease was found in the risk of serious adverse events (RR=0.75 (95% CI 0.62 to 0.90), p=0.0003, low quality); however, no difference was found in the risk of respiratory failure (RR=0.85 (95% CI 0.41 to 1.77), p=0.67, very low quality evidence) with remdesivir.

Conclusions

As per the evidence from current review, remdesivir has shown no mortality benefit (moderate quality evidence) in the treatment of COVID-19. From a cost-benefit perspective, it is our personal opinion that it should not be recommended for use, especially in low and lower middle income countries.

Trial registration number

PROSPERO registration number: CRD42020189517.

SUBMITTER: Singh S

PROVIDER: S-EPMC8228818 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Efficacy and safety of remdesivir in COVID-19 caused by SARS-CoV-2: a systematic review and meta-analysis.

Singh Surjit S Khera Daisy D Chugh Ankita A Khera Pushpinder Singh PS Chugh Vinay Kumar VK

BMJ open 20210624 6

<h4>Objectives</h4>Evaluation of remdesivir, an RNA polymerase inhibitor, for effectiveness in adults with COVID-19.<h4>Data sources</h4>Electronic search for eligible articles of PubMed, Cochrane Central and clinicaltrials.gov was performed on 20 September 2020.<h4>Participants and study eligibility criteria</h4>Only randomised controlled trials (RCTs) evaluating efficacy of remdesivir in COVID-19 were included for meta-analysis.<h4>Interventions</h4>Remdesivir was compared with standard of car ...[more]

PMID: 34168031

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Dataset Information

Efficacy and safety of remdesivir in COVID-19 caused by SARS-CoV-2: a systematic review and meta-analysis.

Objectives

Data sources

Participants and study eligibility criteria

Interventions

Primary and secondary outcomes

Study appraisal and synthesis methods

Results

Conclusions

Trial registration number

Publications

Efficacy and safety of remdesivir in COVID-19 caused by SARS-CoV-2: a systematic review and meta-analysis.

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