Effectiveness of remdesivir for the treatment of hospitalized COVID-19 persons: A network meta-analysis.

Abstract

Several randomized clinical trials (RCTs) that investigated the effectiveness of remdesivir for the treatment of coronavirus disease‐2019 (COVID‐19) have generated inconsistent evidence. The present study aimed to synthesize available RCT evidence using network meta‐analyses (NMAs). Both blinded and open‐label RCTs in PubMed database from inception to 7 June 2020 that contained “remdesivir”, “Covid‐19”, and “trial” in the abstracts conducted on hospitalized COVID‐19 persons were identified and screened. The studies must have at least one remdesivir arm and evaluated one of the pre‐specified outcomes. The outcomes were clinical improvement between days 10 to 15 after randomization and clinical recovery during the follow‐up period. The identified literature was supplemented with relatively recent studies that were known to the researchers if not already included. Frequentist NMAs with random effects were conducted. Both 10‐day and 5‐day remdesivir regimens were associated with higher odds of clinical improvement (odds ratio [OR] of 10‐day regimen: 1.35, 95% confidence interval [CI], 1.09‐1.67); OR of 5‐day regimen: 1.81, 95% CI, 1.32‐2.45, and higher probabilities of clinical recovery (relative risk [RR] of 10‐day regimen: 1.24, 95% CI, 1.07‐1.43; RR of 5‐day regimen: 1.47, 95% CI, 1.16‐1.87 compared with placebo. Remdesivir may have clinical benefits among hospitalized COVID‐19 persons.