Literature Review of the Efficacy and Safety of Remdesivir in the Treatment of COVID-19

Abstract

Remdesivir is a nucleotide analog that demonstrates antiviral activity by decreasing viral RNA production inside the host cells. In this literature review, we aimed to evaluate the efficacy and safety of remdesivir in the treatment of COVID-19. A total of 168 articles were identified in the Pubmed and Embase databases. Six clinical trial articles (two placebo-controlled and four open-labeled) and two re-analysis articles were selected for this review. Evaluation of efficacy in the two placebo-controlled prospective trials showed contradictory results. However, re-analysis of the clinical trials revealed that remdesivir was significantly effective in treating moderately severe COVID-19, while it failed to be effective in the treatment of the critically ill patient subgroup, requiring invasive mechanical ventilation. To treat moderately severe COVID-19 disease, a 5-day treatment is recommended since there was no significant difference between the 5-day and 10-day regimens. Severe adverse events were more frequently reported in the placebo group than in the remdesivir group because adequate COVID-19 treatment was not provided to the placebo group. Although remdesivir is a single option in the treatment of COVID-19 currently, clinicians should be aware of the risk of possible fatal side effects that have not yet been reported. Further studies are warranted to establish the efficacy and safety of remdesivir in the treatment of COVID-19.