New Cochrane review: Remdesivir for the treatment of Covid-19
A new Cochrane review published today weighs up the evidence on the effects of treating COVID-19 with remdesivir.
Remdesivir is an antiviral medicine that fights viruses. It has been shown to prevent the virus that causes COVID-19 (SARS-CoV-2) from reproducing.
The key findings of this latest Cochrane review are:
For adults hospitalised with COVID-19, remdesivir probably has little or no effect on deaths from any cause up to 28 days after treatment compared with placebo (sham treatment) or usual care.
The review authors are uncertain whether remdesivir improves or worsens patients’ condition, based on whether they needed more or less help with breathing.
Researchers should agree on key outcomes to be used in COVID-19 research, and future studies should investigate these areas. This would allow future updates of this review to draw more certain conclusions about the use of remdesivir to treat COVID-19.
People with COVID-19 are given different kinds of breathing support, depending on how severe their breathing difficulties are. For this review, Cochrane authors used the types of breathing support people received as a measure of the success of remdesivir in treating COVID-19.
Types of breathing support included:
for severe breathing difficulties: invasive mechanical ventilation, when a breathing tube is put into patients’ lungs, and a machine (ventilator) breathes for them. Patients are given medicine to make them sedated whilst they are on a ventilator.
for moderate to severe breathing difficulties: non-invasive mechanical ventilation through a mask over the nose and/or mouth, or a helmet. Air or oxygen is pushed through the mask. Patients are generally awake for this treatment.
for moderate breathing difficulties: oxygen via a mask or prongs that sit in the nostrils. Patients can still breathe room air.
The review looked at the following outcomes:
deaths from any cause in the 28 days after treatment;
whether patients got better after treatment, measured by how long they spent on mechanical ventilation or oxygen;
whether patients’ condition worsened so that they needed oxygen or mechanical ventilation;
quality of life;
any unwanted effects; and
serious unwanted effects.
The review includes 5 studies with 7,452 people hospitalised with COVID-19. Of these, 3,886 people were given remdesivir. The average age of patients was 59 years. Studies took place around the world, mainly in high- and upper-middle-income countries.
