Evidence map›Paper›PMID 36828006›Full record

SynthesisThe Lancet. Respiratory medicine2023

Effects of remdesivir in patients hospitalised with COVID-19: a systematic review and individual patient data meta-analysis of randomised controlled trials.

Alain Amstutz, Benjamin Speich, France Mentré, Corina Silvia Rueegg, Drifa Belhadi, Lambert Assoumou, Charles Burdet, Srinivas Murthy, Lori Elizabeth Dodd, Yeming Wang and 25 more

Erratum issued Registry-linked trialOpen access · bronzeAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Lancet. Respiratory medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. 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 76 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
76citing papers in PubMed, 6 pooled it
24.3field-weighted citation impact, top 1% 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.

NCT04315948 phase3completednot on this map

Multi-centre, Adaptive, Randomized Trial of the Safety and Efficacy of Treatments of COVID-19 in Hospitalized Adults

TypeinterventionalSponsorInstitut National de la Santé Et de la Recherche Médicale, FranceRan2020 to 2023Enrolled1,552ConditionsCorona Virus InfectionArmsRemdesivir, Lopinavir/ritonavir, Interferon Beta-1A, Hydroxychloroquine, Standard of care
3 · Its place in the literature

Who cites it

76 citing papers in PubMed, 6 syntheses or guidelines pooled it, 123 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  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
    Trial
  9. Trial
  10. Article
  11. Real-world effectiveness of early remdesivir in reducing mortality among vulnerable patients hospitalized for COVID-19: Evidence for clinical pharmacists and inpatient care providers.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2026
    Article
  12. Review
  13. Review
  14. Article
  15. Article
  16. Observational
  17. Acute SARS-CoV-2 infection.Nature reviews. Disease primers · 2025
    Review
  18. Viral Dynamic Models During COVID-19: Are We Ready for the Next Pandemic?CPT: pharmacometrics & systems pharmacology · 2025
    Review
  19. Article
  20. Article

16 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

35 authors at 20 institutions in 8 countries.

Alain AmstutzCLEAR Methods Center, Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Benjamin SpeichCLEAR Methods Center, Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland. Electronic address: benjamin.speich@usb.ch.
France MentréUniversité Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, France; Département d'Épidémiologie, Biostatistique et Recherche Clinique, Hôpital Bichat, AP-HP, Paris, France.
Corina Silvia RueeggOslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
Drifa BelhadiUniversité Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, France; Département d'Épidémiologie, Biostatistique et Recherche Clinique, Hôpital Bichat, AP-HP, Paris, France.
Lambert AssoumouUniversité Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, France.
Charles BurdetUniversité Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, France; Département d'Épidémiologie, Biostatistique et Recherche Clinique, Hôpital Bichat, AP-HP, Paris, France.
Srinivas MurthyDepartment of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Lori Elizabeth DoddClinical Trials Research Section, Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA.
Yeming WangDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China.
Kari A O TikkinenDepartment of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Surgery, South Karelian Central Hospital, Lappeenranta, Finland.
Florence AderDépartement des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France; Legiopath, Centre International de Recherche en Infectiologie, Inserm 1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, École Normale Supérieure de Lyon, Univ Lyon, Lyon, France.
Maya HitesCliniques Universitaires de Bruxelles Hôpital Érasme, Université Libre de Bruxelles, Clinique des Maladies Infectieuses, Brussels, Belgium.
Maude BouscambertLaboratoire de Virologie, Institut des Agents Infectieux de Lyon, Centre National de Référence des Virus Respiratoires France Sud, Hospices Civils de Lyon, Lyon, France.
Mary Anne TrabaudLaboratoire de Virologie, Institut des Agents Infectieux de Lyon, Centre National de Référence des Virus Respiratoires France Sud, Hospices Civils de Lyon, Lyon, France.
Mike FralickDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Todd C LeeClinical Practice Assessment Unit, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada.
Ruxandra PintoDepartment of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Andreas Barratt-DueDepartment of Anesthesia and Intensive Care Medicine, Oslo University Hospital, Oslo, Norway.
Fridtjof Lund-JohansenDepartment of Anesthesia and Intensive Care Medicine, Oslo University Hospital, Oslo, Norway.
Fredrik MüllerDepartment of Anesthesia and Intensive Care Medicine, Oslo University Hospital, Oslo, Norway.
Olli P O NevalainenHatanpää Health Centre, Tampere, Finland.
Bin CaoDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; National Clinical Research Center for Respiratory Diseases, Beijing, China.
Tyler BonnettClinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, National Institutes of Health, Frederick, MD, USA.
Alexandra GriessbachCLEAR Methods Center, Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Ala Taji HeraviCLEAR Methods Center, Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Christof SchönenbergerCLEAR Methods Center, Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Perrine JaniaudDepartment of Clinical Research, University Hospital Basel, Basel, Switzerland.
Laura WerlenDepartment of Clinical Research, University Hospital Basel, Basel, Switzerland.
Soheila AghlmandiCLEAR Methods Center, Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Stefan SchandelmaierCLEAR Methods Center, Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
Yazdan YazdanpanahUniversité Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, France; Service de Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France.
Dominique CostagliolaSorbonne Université, Inserm, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, Paris, France.
Inge Christoffer OlsenOslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
Matthias BrielCLEAR Methods Center, Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland; Department of Health Research Methodology, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
University Hospital of Basel · CHOslo University Hospital · NOHospices Civils de Lyon · FRNational Clinical Research Center for Digestive Diseases · CNErasmus Hospital · BEHatanpää Hospital · FIHôpital Bichat-Claude-Bernard · FRInserm · FRMcGill University Health Centre · CAMcMaster University · CANational Institute of Allergy and Infectious Diseases · USNational Institutes of Health · USSorbonne Paris Cité · FRSorbonne Université · FRSouth Karelia Central Hospital · FISunnybrook Health Science Centre · CAUniversité Paris Cité · FRUniversité Sorbonne Paris Nord · FRUniversity of British Columbia · CAUniversity of Toronto · CA

Funding

Intramural NIH HHS Z99 AI999999
6 · The paper itself

Abstract

backgroundInterpretation of the evidence from randomised controlled trials (RCTs) of remdesivir in patients treated in hospital for COVID-19 is conflicting. We aimed to assess the benefits and harms of remdesivir compared with placebo or usual care in these patients, and whether treatment effects differed between prespecified patient subgroups.

methodsFor this systematic review and meta-analysis, we searched PubMed, Embase, the Cochrane COVID-19 trial registry, ClinicalTrials.gov, the International Clinical Trials Registry Platform, and preprint servers from Jan 1, 2020, until April 11, 2022, for RCTs of remdesivir in adult patients hospitalised with COVID-19, and contacted the authors of eligible trials to request individual patient data. The primary outcome was all-cause mortality at day 28 after randomisation. We used multivariable hierarchical regression-adjusting for respiratory support, age, and enrollment period-to investigate effect modifiers. This study was registered with PROSPERO, CRD42021257134.

findingsOur search identified 857 records, yielding nine RCTs eligible for inclusion. Of these nine eligible RCTs, individual data were provided for eight, covering 10 480 patients hospitalised with COVID-19 (99% of such patients included in such RCTs worldwide) recruited between Feb 6, 2020, and April 1, 2021. Within 28 days of randomisation, 662 (12·5%) of 5317 patients assigned to remdesivir and 706 (14·1%) of 5005 patients assigned to no remdesivir died (adjusted odds ratio [aOR] 0·88, 95% CI 0·78-1·00, p=0·045). We found evidence for a credible subgroup effect according to respiratory support at baseline (p

interpretationThis individual patient data meta-analysis showed that remdesivir reduced mortality in patients hospitalised with COVID-19 who required no or conventional oxygen support, but was underpowered to evaluate patients who were ventilated when receiving remdesivir. The effect size of remdesivir in patients with more respiratory support or acquired immunity and the cost-effectiveness of remdesivir remain to be further elucidated.

fundingEU-RESPONSE.

Indexed as

COVID-19AdultCOVID-19 Drug TreatmentHumans

Identifiers

PMID36828006
PMCPMC10156140
OpenAlexW4321502829

What OpenQuestion holds

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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.