Remdesivir Use Improves Mortality in COVID-19 in Non-ventilated Hospitalized Patients

Dr. Gibson Clinical question: Does remdesivir have a mortality benefit in patients with COVID-19? Background: The Solidarity trial previously reported preliminary mortality analyses for remdesivir, lopinavir, hydroxychloroquine, and interferon beta-1a use in COVID-19 inpatients. The latter three drugs were discontinued due to futility, but randomization to remdesivir continued. This review presents the final results of the Solidarity trial and all other relevant trials of remdesivir at the time of publication. Study design: Randomized control trial and meta-analysis Setting: Inpatients with COVID-19 infection from 454 hospitals in 35 countries in World Health Organization (WHO) regions between March 2020 and January 2021. These results were compared to a systematic review of the WHO Cochrane database for published COVID-19 treatment randomized inpatient trials. Synopsis: A total of 8,275 patients were randomly allocated (1:1) to remdesivir or control (local standard of care, no placebo). For the study’s primary endpoint of in-hospital mortality, findings were similar to the preliminary results. Patients not ventilated who received remdesivir had lower mortality than those who did not; all those not ventilated (11.9% versus 13.5%; P=0.02) and patients not ventilated but on oxygen (14.6% versus 16.3%; P=0.03). There was no statistically significant difference in overall mortality, mortality of those already ventilated, or mortality in those not ventilated and not on oxygen. ...
Source: The Hospitalist - Category: Hospital Management Authors: Tags: COVID-19 In the Literature Source Type: research