Author:
Chen Chuizhe,Fang Junde,Chen Shu,Rajaofera Mamy Jayne Nelly,Li Xuemiao,Wang Bo,Xia Qianfeng
Abstract
Abstract
Background
Remdesivir is considered to be a specific drug for treating coronavirus disease 2019. This systematic review aims to evaluate the clinical efficacy and risk of remdesivir alone and in combination with other drugs.
Research design and methods
The PubMed, Embase, SCIE, Cochrane Library, and American Clinical trial Center databases were searched up to 1 April 2022 to identify. Randomized controlled trials (RCTs) and observational studies comparing the efficacy of remdesivir monotherapy and combination therapy with that of control drugs.
Results
Ten RCTs and 32 observational studies were included in the analysis. Regarding the primary outcome, remdesivir use reduced mortality in patients with severe COVID-19 (RR = 0.57, 95% CI (0.48,0.68)) and shortened the time to clinical improvement (MD = -2.51, 95% CI (-2.75, -2.28)). Regarding other clinical outcomes, remdesivir use was associated with improved clinical status (RR = 1.08, 95%CI (1.01, 1.17)). Regarding safety outcomes, remdesivir use did not cause liver or kidney damage (RR = 0.87, 95%CI (0.68, 1.11)) (RR = 0.88, 95%CI (0.70,1.10)). Compared with remdesivir alone, remdesivir combined with other drugs (e.g., steroids, favipiravir, and convalescent plasma) had no effect on mortality.
Conclusion
The use of remdesivir can help to reduce the mortality of patients with severe COVID-19 and shorten the time to clinical improvement. There was no benefit of remdesivir combination therapy for other clinical outcomes.
Trial registration
PROSPERO registration number: CRD42022322859.
Funder
Hainan Provincial Natural Science Foundation of China
Youth Cultivation Fundation of Hainan Medical University
National Natural Science Foundation of China
Pathogenic spectrum, diagnosis and treatment of tick-borne infectious diseases in eastern of Inner Mongolia
Open Foundation of NHC Key Laboratory of Control of Tropical diseases
National Major Special Project for Infectious Diseases of China
Publisher
Springer Science and Business Media LLC
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