Evidence map›Paper›PMID 34168031›Full record

SynthesisBMJ open2021

Efficacy and safety of remdesivir in COVID-19 caused by SARS-CoV-2: a systematic review and meta-analysis.

Surjit Singh, Daisy Khera, Ankita Chugh, Pushpinder Singh Khera, Vinay Kumar Chugh

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 7 pooled it
4.1field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 7 syntheses or guidelines pooled it, 64 citations in OpenAlex.

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  7. Use of remdesivir in patients with COVID-19: a systematic review and meta-analysis.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia
    Pooled it
  8. Cardiac Adverse Events and Remdesivir in Hospitalized Patients With COVID-19: A Post Hoc Safety Analysis of the Randomized DisCoVeRy Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Surjit Singh *Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India.ORCID 0000-0002-8990-3235
Daisy Khera *Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Ankita Chugh *Department of Dentistry, All India Institute of Medical Sciences, New Delhi, India ankitamody@gmail.com.
Pushpinder Singh KheraDepartment of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.
Vinay Kumar ChughDepartment of Dentistry, All India Institute of Medical Sciences, New Delhi, India.
All India Institute of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesEvaluation of remdesivir, an RNA polymerase inhibitor, for effectiveness in adults with COVID-19. DATA SOURCES: Electronic search for eligible articles of PubMed, Cochrane Central and clinicaltrials.gov was performed on 20 September 2020. PARTICIPANTS AND STUDY ELIGIBILITY CRITERIA: Only randomised controlled trials (RCTs) evaluating efficacy of remdesivir in COVID-19 were included for meta-analysis.

interventionsRemdesivir was compared with standard of care. PRIMARY AND SECONDARY OUTCOMES: Primary outcome was mortality and secondary outcomes were time to clinical improvement and safety outcomes like serious adverse events, respiratory failure. STUDY APPRAISAL AND SYNTHESIS

methodsData synthesis was done with Cochrane review manager 5 (RevMan) V.5.3. Cochrane risk of bias V.2.0 tool was used for methodological quality assessment. The GRADE pro GDT was applied for overall quality of evidence.

results52 RCTs were screened and 4 studies were included in analysis, with total of 7324 patients. No mortality benefit was observed with remdesivir versus control group (OR=0.92 (95% CI 0.79 to 1.07), p=0.30, moderate quality evidence). Significantly higher rates of clinical improvement (OR=1.52 (95% CI 1.24 to 1.87), p<0.0001, low quality) and faster time to clinical improvement (HR=1.28 (95% CI 1.12 to 1.46), p=0.0002, very low quality) was observed with remdesivir versus control group. Significant decrease was found in the risk of serious adverse events (RR=0.75 (95% CI 0.62 to 0.90), p=0.0003, low quality); however, no difference was found in the risk of respiratory failure (RR=0.85 (95% CI 0.41 to 1.77), p=0.67, very low quality evidence) with remdesivir.

conclusionsAs per the evidence from current review, remdesivir has shown no mortality benefit (moderate quality evidence) in the treatment of COVID-19. From a cost-benefit perspective, it is our personal opinion that it should not be recommended for use, especially in low and lower middle income countries. TRIAL REGISTRATION NUMBER: PROSPERO registration number: CRD42020189517.

Indexed as

COVID-19 Drug TreatmentAdenosine MonophosphateAdultAlanineAntiviral AgentsHumansSARS-CoV-2Adenosine MonophosphateAlanineAntiviral Agentsremdesivirclinical pharmacologyCOVID-19immunologyrespiratory infections

Identifiers

PMID34168031
PMCPMC8228818
OpenAlexW3175818920

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.