Trial reportThe Journal of antimicrobial chemotherapy2022
Effect of remdesivir on viral dynamics in COVID-19 hospitalized patients: a modelling analysis of the randomized, controlled, open-label DisCoVeRy trial.
Trial report in The Journal of antimicrobial chemotherapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04315948 (Multi-centre, Adaptive, Randomized Trial of the Safety and Efficacy of Treatments of COVID-19 in Hospitalized Adults), which is not on this map. Cited by 30 papers, 2 of them syntheses that pooled 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.
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.
Multi-centre, Adaptive, Randomized Trial of the Safety and Efficacy of Treatments of COVID-19 in Hospitalized Adults
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Effects of remdesivir in patients hospitalised with COVID-19: a systematic review and individual patient data meta-analysis of randomised controlled trials.The Lancet. Respiratory medicine · 2023Pooled it
- Remdesivir for the treatment of COVID-19.The Cochrane database of systematic reviews · 2023Pooled it
- Antiviral effect of Evusheld in COVID-19 hospitalized patients infected with pre-Omicron or Omicron variants: a modelling analysis of the randomized DisCoVeRy trial.The Journal of antimicrobial chemotherapy · 2024Trial
- SARS-CoV-2 RNA and Nucleocapsid Antigen Are Blood Biomarkers Associated With Severe Disease Outcomes That Improve in Response to Remdesivir.The Journal of infectious diseases · 2024Trial
- Association between SARS-CoV-2 viral kinetics and clinical score evolution in hospitalized patients.CPT: pharmacometrics & systems pharmacology · 2023Trial
- High Nasopharyngeal SARS-CoV-2 Load and Delayed Clearance in Hospitalized Patients With Blood Autoantibodies Neutralizing Type I Interferons.The Journal of infectious diseases · 2026Article
- Ordinary differential equation models of SARS-CoV-2 replication dynamics and antiviral drug efficacies.Npj viruses · 2026Review
- Review
- Remdesivir in COVID-19: pros and cons.Frontiers in pharmacology · 2026Review
- Association of remdesivir treatment with long-term mortality after COVID-19 hospitalization.BMC infectious diseases · 2025Observational
- Viral Dynamic Models During COVID-19: Are We Ready for the Next Pandemic?CPT: pharmacometrics & systems pharmacology · 2025Review
- Modelling the effectiveness of antiviral treatment strategies to prevent household transmission of acute respiratory viruses.PLoS computational biology · 2024Article
- The kinetics of SARS-CoV-2 infection based on a human challenge study.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Within-host dynamics of antiviral treatment with remdesivir for SARS-CoV-2 infection.Journal of the Royal Society, Interface · 2024Article
- SARS-CoV-2 viral load is linked to remdesivir efficacy in severe Covid-19 admitted to intensive care.Scientific reports · 2024Article
- COVID-19 therapeutics.Clinical microbiology reviews · 2024Review
- Modeling the emergence of viral resistance for SARS-CoV-2 during treatment with an anti-spike monoclonal antibody.PLoS pathogens · 2024Article
- Effects of remdesivir on SARS-CoV-2 viral dynamics and mortality in viraemic patients hospitalized for COVID-19.The Journal of antimicrobial chemotherapy · 2023Article
- Modeling the emergence of viral resistance for SARS-CoV-2 during treatment with an anti-spike monoclonal antibody.bioRxiv : the preprint server for biology · 2023Article
- Remdesivir: A Review in COVID-19.Drugs · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors at 8 institutions in 6 countries.
Funding
Abstract
backgroundThe antiviral efficacy of remdesivir in COVID-19 hospitalized patients remains controversial.
objectivesTo estimate the effect of remdesivir in blocking viral replication.
methodsWe analysed nasopharyngeal normalized viral loads from 665 hospitalized patients included in the DisCoVeRy trial (NCT04315948; EudraCT 2020-000936-23), randomized to either standard of care (SoC) or SoC + remdesivir. We used a mathematical model to reconstruct viral kinetic profiles and estimate the antiviral efficacy of remdesivir in blocking viral replication. Additional analyses were conducted stratified on time of treatment initiation (≤7 or >7 days since symptom onset) or viral load at randomization (< or ≥3.5 log10 copies/104 cells).
resultsIn our model, remdesivir reduced viral production by infected cells by 2-fold on average (95% CI: 1.5-3.2-fold). Model-based simulations predict that remdesivir reduced time to viral clearance by 0.7 days compared with SoC, with large inter-individual variabilities (IQR: 0.0-1.3 days). Remdesivir had a larger impact in patients with high viral load at randomization, reducing viral production by 5-fold on average (95% CI: 2.8-25-fold) and the median time to viral clearance by 2.4 days (IQR: 0.9-4.5 days).
conclusionsRemdesivir halved viral production, leading to a median reduction of 0.7 days in the time to viral clearance compared with SoC. The efficacy was larger in patients with high viral load at randomization.
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What OpenQuestion holds
Registered trials
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.