AUTHOR=Bansal Vikas , Mahapure Kiran S. , Bhurwal Abhishek , Gupta Ishita , Hassanain Sahar , Makadia Janaki , Madas Nimisha , Armaly Paige , Singh Romil , Mehra Ishita , O'Horo John C. , Kashyap Rahul 

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

JOURNAL=Frontiers in Medicine

VOLUME=7

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2020.606429

DOI=10.3389/fmed.2020.606429

ISSN=2296-858X

ABSTRACT=<p><bold>Importance/Background:</bold> 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.</p><p><bold>Methods:</bold> 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.</p><p><bold>Statistical Analysis:</bold> All outcomes were performed using Comprehensive Meta-Analysis software package (Bio stat, Englewood, NJ, USA).</p><p><bold>Results:</bold> 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; <italic>I</italic><sup>2</sup> = 97.24) and the pooled mortality rate was 11.3% (95% CI 7.9–16%; <italic>I</italic><sup>2</sup> = 74.85). However, treatment with Remdesivir was associated with adverse effects (55.3%, 95% CI 31.5–76.9%; <italic>I</italic><sup>2</sup> = 97.66) eventually warranting the discontinuation of the drug (17.8%, 95% CI 8.6–33.1%; <italic>I</italic><sup>2</sup> = 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, <italic>p</italic> ≤ 0.001; <italic>I</italic><sup>2</sup> = 16.6).</p><p><bold>Conclusions and Relevance:</bold> 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.</p>