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Efficacy and safety of remdesivir in hospitalised COVID-19 patients: a systematic review and meta-analysis

journal contribution
posted on 2023-05-21, 03:15 authored by Angamo, MT, Mohammed, MA, Gregory PetersonGregory Peterson

Purpose: This review was aimed to synthesise the best available evidence on the effectiveness and safety of remdesivir in the treatment of moderate to severe COVID-19.

Method: Randomised controlled trials (RCTs) and observational studies reporting the effectiveness and safety of remdesivir were searched via databases and other sources from December 2019 to December 2020. Two independent reviewers performed literature screening, data extraction and assessment of risk bias. Seven studies involving 3686 patients were included.

Results: Treatment with remdesivir was associated with an increase in clinical recovery rate by 21% (RR 1.21; 95% CI 1.08-1.35) on day 7 and 29% (RR 1.29; 95% CI 1.22-1.37) on day 14. The likelihoods of requiring high-flow supplemental oxygen and invasive mechanical ventilation in the remdesivir group were lower than in the placebo group by 27% (RR 0.73; 95% CI 0.54-0.99) and 47% (RR 0.53; 95% CI 0.39-0.72), respectively. Remdesivir-treated patients showed a 39% (RR 0.61; 95% CI 0.46-0.79) reduction in the risk of mortality on day 14 compared to the control group; however, there was no significant difference on day 28. Serious adverse effects (SAEs) were significantly less common in patients treated with remdesivir, with an absolute risk difference of 6% (RD -0.06; 95% CI -0.09 to -0.03).

Conclusion: Despite conditional recommendation against its use, remdesivir could still be effective in early clinical improvement; reduction of early mortality and avoiding high-flow supplemental oxygen and invasive mechanical ventilation among hospitalised COVID-19 patients. Remdesivir was also well tolerated without significant SAEs compared to placebo, yet available evidence from clinical studies support the need to conduct close monitoring.


Publication title

Infection: Journal of Infectious Disease






School of Pharmacy and Pharmacology


Mmv Medien & Medizin Verlagsgesellschaft Mbh

Place of publication

Neumarkter Str 18, Munich, Germany, D-81673

Rights statement

© Crown 2021

Repository Status

  • Restricted

Socio-economic Objectives

Efficacy of medications; Treatment of human diseases and conditions

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