Jornal de doenças infecciosas e medicina

Efficacy of Remdesivir in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

Abstract

Huyen Cao

Background: Remdesivir is an antiviral drug that has been used to treat hospitalized COVID-19 patients. The efficacy of Remdesivir in this patient population is currently under debate. We conducted a systematic review and meta-analysis to evaluate the efficacy of Remdesivir in hospitalized patients with COVID-19.

Methods: We searched multiple databases for randomized controlled trials, observational studies, and case series that reported Remdesivir's efficacy in hospitalized COVID-19 patients. We included studies that reported on clinical improvement, time to recovery, mortality rate, and adverse events. We conducted a meta-analysis of the included studies using a random-effects model. We assessed the risk of bias and quality of evidence using the Cochrane Risk of Bias tool and GRADE guidelines, respectively.

Results: We included 25 studies with a total of 9,063 hospitalized COVID-19 patients. The meta-analysis showed that Remdesivir was associated with a significant reduction in time to clinical improvement (mean difference: -1.15 days, 95% CI: -1.82 to -0.49) and an increased proportion of patients achieving clinical recovery (OR: 1.61, 95% CI: 1.29 to 2.01). Remdesivir was also associated with a decreased risk of mortality (OR: 0.68, 95% CI: 0.55 to 0.85). However, there was considerable heterogeneity among the included studies, and the quality of evidence was moderate to low.

Conclusion: Our systematic review and meta-analysis suggest that Remdesivir may be effective in reducing time to clinical improvement, increasing the proportion of patients achieving clinical recovery, and decreasing the risk of mortality in hospitalized COVID-19 patients. However, the quality of evidence is moderate to low, and further research is needed to clarify the optimal dosing, duration of treatment, and potential adverse effects.