Mortality Benefit of Remdesivir in COVID-19: A Systematic Review and Meta-Analysis

Frontiers in Medicine

article

Vikas Bansal¹  Ishita Mehra²  John C. O'Horo⁴  Rahul Kashyap¹  Kiran S. Mahapure⁵  Abhishek Bhurwal⁶  Ishita Gupta⁷  Sahar Hassanain⁸  Janaki Makadia⁹  Nimisha Madas^1,10  Paige Armaly^1,11  Romil Singh^1,12 

[1] Department of Anaesthesiology and Critical Care Medicine, Mayo Clinic, United States;Division of Pulmonary, Sleep and Critical Care Medicine, Mayo Clinic, United States;Department of Internal Medicine, North Alabama Medical Center, United States;Department of Infectious Disease, Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, United States;Department of Plastic Surgery, KAHER J. N. Medical College;Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson School of Medicine, United States;Dr. Rajendra Prasad Government Medical College;Women Medical College;Gujrat Medical Education and Research Society Medical College;Mamata Medical College;University of the West Indies;Departments of Medicine, Metropolitan Hospital

关键词: Remdesivir (GS-5734);    COVID-19;    SARS-CoV-2;    mortality;    systematic review;    meta-analysis;   

DOI  :  10.3389/fmed.2020.606429

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Importance/Background: During current public health emergency of COVID-19 pandemic, repurposing of existing antiviral drugs may be an efficient strategy since there is no proven effective treatment. Published literature shows Remdesivir has broad-spectrum antiviral activity against numerous RNA viruses and has been recently recognized as a promising therapy against SARS-CoV-2. Methods: A systematic search was conducted for full length manuscripts published between inception and July 19th, 2020 focussing on efficacy and safety of Remdesivir in COVID-19. The primary outcomes were defined as mortality rate and median days to recovery based on the available pooled data. The secondary outcome was adverse events rate and drug discontinuation rate. Statistical Analysis: All outcomes were performed using Comprehensive Meta-Analysis software package (Bio stat, Englewood, NJ, USA). Results: A total of 1,895 patients from 9 studies were included in this qualitative synthesis. In patients treated with Remdesivir, the mean recovery time was 15.84 days (95% CI 11.68–20, SE 2.12; I 2 = 97.24) and the pooled mortality rate was 11.3% (95% CI 7.9–16%; I 2 = 74.85). However, treatment with Remdesivir was associated with adverse effects (55.3%, 95% CI 31.5–76.9%; I 2 = 97.66) eventually warranting the discontinuation of the drug (17.8%, 95% CI 8.6–33.1%; I 2 = 95.64). The meta-analysis of three clinical trials indicated that administration of Remdesivir significantly reduces the mortality compared to the placebo (OR 0.70, 95% CI 0.58–0.84, p ≤ 0.001; I 2 = 16.6). Conclusions and Relevance: The result of contemporary meta-analysis suggests mortality benefit with Remdesivir in COVID-19 and median recovery time was over 2 weeks. The pooled mortality with Remdesivir was found to be very low, and this analysis can shed light on this potential treatment for COVID-19 patients.

【 授权许可】

CC BY