Cochrane · systematic review · CD014962
Remdesivir for the treatment of COVID‐19
Grundeis, F, Ansems, K, Dahms, K, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
13
current version
GRADE rated
11
No studies
1
Included studies
NR
No studies 1 · 7.7%Ungraded 1 · 7.7%Very low 1 · 7.7%Low 3 · 23.1%Moderate 7 · 53.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyRemdesivir and standard care versus standard care (plus/minus placebo) for individuals with moderate to severe COVID‐19
Population: hospitalised adults with moderate to severe COVID‐19
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality at up to day 281 Remdesivir and standard care vs standard care (plus/minus placebo) | RR 0.93 [0.81, 1.06] | 4 studies · 7142 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
All‐cause mortality at up to day 60 Remdesivir and standard care vs standard care (plus/minus placebo) | RR 0.85 [0.69, 1.05] | 1 study · 1281 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
In‐hospital mortality at up to day 150 Remdesivir and standard care vs standard care (plus/minus placebo) | RR 0.93 [0.84, 1.03] | 1 study · 8275 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Clinical improvement: participants alive and ready to be discharged at up to day 282 Remdesivir and standard care vs standard care (plus/minus placebo) | RR 1.11 [1.06, 1.17] | 4 studies · 2514 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Clinical worsening: time to new need for invasive mechanical ventilation or death within 28 days3 Remdesivir and standard care vs standard care (plus/minus placebo) | HR 0.67 [0.54, 0.82] | 2 studies · 1734 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Adverse events (any grade) at up to day 28 Remdesivir and standard care vs standard care (plus/minus placebo) | RR 1.04 [0.92, 1.18] | 4 studies · 2498 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Serious adverse events at up to day 28 Remdesivir and standard care vs standard care (plus/minus placebo) | RR 0.84 [0.65, 1.07] | 4 studies · 2498 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Remdesivir and standard care versus standard care (plus/minus placebo) for individuals with asymptomatic SARS‐CoV‐2 infection or mild COVID‐19
Population: non‐hospitalised adults with mild COVID‐19
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality at up to day 28 Remdesivir and standard care vs standard care (plus/minus placebo) | no estimate extracted | 1 study · 562 participants | Ungraded |
Clinical improvement: participants with symptom alleviation at up to day 14 Remdesivir and standard care vs standard care (plus/minus placebo) | HR 1.41 [0.73, 2.71] | 1 study · 126 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Clinical worsening: participants admitted to hospital or deceased at up to day 28 Remdesivir and standard care vs standard care (plus/minus placebo) | RR 0.28 [0.11, 0.75] | 1 study · 562 participants | Moderate Downgraded: imprecision |
Quality of life Remdesivir and standard care vs standard care (plus/minus placebo) | no estimate extracted | NR | No studies |
Serious adverse events at up to day 28 Remdesivir and standard care vs standard care (plus/minus placebo) | RR 0.27 [0.1, 0.7] | 1 study · 562 participants | Low Downgraded: imprecision, indirectness |
Adverse events (any grade) at up to day 28 Remdesivir and standard care vs standard care (plus/minus placebo) | RR 0.91 [0.76, 1.1] | 1 study · 562 participants | Moderate Downgraded: imprecision |
Remdesivir compared to placebo or standard care alone for hospitalised adults with confirmed SARS‐CoV‐2 infection
Population: hospitalised adults with confirmed SARS‐CoV‐2 infection
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality at up to day 28 Remdesivir vs placebo or standard care alone | RR 0.93 [0.81, 1.06] | 4 studies · 7142 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Improvement of clinical status: duration to liberation from invasive mechanical ventilation at up to day 28 Remdesivir vs placebo or standard care alone | no estimate extracted | 2 studies · 1298 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Improvement of clinical status: duration to liberation from supplemental oxygen at up to day 28 Remdesivir vs placebo or standard care alone | HR 1.93 | 3 studies · 1691 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Clinical worsening: new need for mechanical ventilation at day 28 (defined as high‐flow oxygen, non‐invasive, or invasive mechanical ventilation) Remdesivir vs placebo or standard care alone | RR 0.78 [0.48, 1.24] | 3 studies · 6696 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Clinical worsening: new need for invasive mechanical ventilation at up to day 28 Remdesivir vs placebo or standard care alone | RR 0.56 [0.41, 0.77] | 2 studies · 1159 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Clinical worsening: new need for non‐invasive mechanical ventilation or high‐flow oxygen at up to day 28Â Remdesivir vs placebo or standard care alone | RR 0.7 [0.51, 0.98] | 1 study · 573 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Clinical worsening: new need for oxygen by mask or nasal prongs at up to day 28Â Remdesivir vs placebo or standard care alone | RR 0.81 [0.54, 1.22] | 1 study · 138 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Quality of life Remdesivir vs placebo or standard care alone | no estimate extracted | NR | No studies |
Serious adverse events at up to day 28 Remdesivir vs placebo or standard care alone | RR 0.75 [0.63, 0.9] | 3 studies · 1674 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Adverse events (any grade) at up to day 28 Remdesivir vs placebo or standard care alone | RR 1.05 [0.86, 1.27] | 3 studies · 1674 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |