60 trial sites across the Europe, Asia, and North America
Adults hospitalized with COVID-19
Evidence of lower respiratory tract infection
200 mg loading dose on day 1, followed by 100 mg daily for up to 9 additional days
Time to recovery (discharge or hospitalization for infection-control purposes only)
Defined as the first day of recovery, during the 28 days after enrollment
Clinical status at day 15
Remdesivir: 541 patients | Placebo: 521 patients
Patients who received remdesivir had a shorter median recovery time
Remdesivir: median 10 days (95% CI, 9 to 11)
Placebo: median 15 days (95% CI, 13 to 18)
Rate ratio for recovery: 1.29 (95% CI, 1.12 to 1.4); P<0.001
Patients who received remdesivir were more likely to have clinical improvement at day 15 (adjusted for disease severity)
Odds ratio 1.5 (95% CI, 1.2 to 1.9)
Benefit “most apparent in patients with a baseline ordinal score of 5 (receiving low-flow oxygen)”
Mortality (estimated using Kaplan–Meier estimation analysis)
By day 15
By day 29
Hazard ratio 0.73 (95% CI, 0.52 to 1.03)
Serious adverse events
For adults with COVID-19 and evidence of lower respiratory tract infection, remdesivir was associated with a shorter time to recovery (by approximately 5 days)
While benefit was primarily in patients on low-flow oxygen, the authors caution that this does not necessarily mean there is no benefit in other categories (i.e., no oxygen, high-flow oxygen, mechanical ventilation or ECMO)
The authors also state that
Our data also suggest that treatment with remdesivir may have prevented the progression to more severe respiratory disease, as shown by the lower proportion of serious adverse events due to respiratory failure among patients in the remdesivir group
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