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], p < 0.001). The odds of early (at day 14/15; OR = 1.42 [95% CI: 1.16; 1.74], p < 0.001) and late (at day 28/29; OR = 1.44 [95% CI: 1.16; 1.79], p = 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], p = 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. Highlights • Remdesivir reduces the odds for mechanical ventilation or extracorporeal membrane oxygenation in COVID-19 patients. • Remdesivir improves the odds for hospital discharge. • Remdesivir does not lower the odds for mortality. • Remdesivir can attenuate COVID-19 progression, but it is less effective in treating critically-ill patients.
【저자키워드】 coronavirus, SARS virus, Antiviral agents, Therapeutic uses, 【초록키워드】 COVID-19, Randomized controlled trial, Treatment, Meta-analysis, Mortality, mechanical ventilation, Remdesivir, systematic review, Disease progression, extracorporeal membrane oxygenation, Patient, ECMO, patients, COVID-19 patients, COVID-19 progression, control group, no difference, hospital discharge, material, systematic literature search, significantly lower, effective, IMPROVE, Result, greater, identify, examined, was performed, less, significantly higher, not affect, reduce, attenuate, patients treated, treatment for COVID-19, 【제목키워드】 Randomized controlled trial, Meta-analysis, therapy, systematic review, Patient,