Table 1

Relevant papers

Author, date, countryPatient groupStudy typeOutcomes measuredResults foundStudy weaknesses
S Antinori et al, Italy1 202035 patients over 18 years of age with confirmed COVID-19 infection requiring mechanical ventilation or had SpO2 ≤94% on room air or national early warning score of ≥4
18 patients were recruited in the intensive care unit and 17 in the infectious disease ward
Patients were allowed to continue their other treatments (including hydroxychloroquine) but had to discontinue other antivirals
37% discontinued the intervention because of side effects
Open-label prospective studyHospitalisation status as primary outcome
Side effects as secondary outcomes
At day 28, 82.3% of patients on the infectious disease ward were discharged and 5.9% had died
33.3% were discharged from intensive care and 44.4% had died with 16.7% still mechanically ventilated
Hepatotoxicity in 42.8% as most common side effect
Presence of confounding factors
No control group
Open-label compassionate single-centre trial
Small size cohort
J Grein et al., 20202 53 patients with confirmed COVID-19 infection with SpO2 ≤94% or who received oxygen support received at least one dose of remdesivir as interventionMulticentre prospective studyImprovement in oxygen support, hospital discharge and adverse eventsAt day 28, the cumulative incidence of improvement was 84%
(95% CI 70 to 99)
Overall mortality was 0.56 per 100 hospitalisations
(95% CI 0.14 to 0.97)
23% of patients developed severe adverse events
No clearly pre-defined endpoints
Open-label compassionate trial
Small size cohort
No control group
Short duration of follow-up
J Goldman et al., USA 20203 Patients with COVID-19 infection with SpO2 ≤94% or receiving supplemental oxygen therapy and radiological evidence of pneumonia
200 patients received remdesivir for 5 days and 197 for 10 days
Patients requiring ventilatory support at baseline were excluded
Randomised, open-label multicentre trialClinical status at day 14 based on an ordinal scale
Adverse events as secondary outcomes
After adjustment for clinical status, both patient groups had similar outcome at day 14 (p=0.14)
70% of patients in the 5-day group experienced adverse events vs 74% in the 10-day group
No placebo control group
Results cannot be extrapolated to critically ill patients
J Beigel et al., 20204 1063 patients with COVID-19 infection and confirmed lower respiratory tract involvement
541 randomised to remdesivir and 522 to placebo
Patients were allowed to receive other supportive treatments
Multicentre double-blind, randomised placebo-controlled trialTime to recovery
Serious adverse events
The intervention group had a shorter recovery time (median days 11 vs 15 in the placebo group)
Rate ratio 1.32 (95% CI 1.12 to 1.55, p<0.001)
Mortality in the intervention group was 7.1% vs 11.9%
HR 0.70 (95% CI 0.47 to 1.04)
Serious adverse events occurred in 21.1% in the intervention group vs 27% in the placebo one
Potential confounders
Unclear what was defined as lower respiratory involvement
Full statistical analysis still ongoing (preliminary report)
Wang et al., China 20205 237 patients with COVID-19 pneumonia confirmed with imaging with SpO2 ≤94% or PaO2/FiO2 ≤300 mm Hg
158 assigned to intervention and 79 to placebo (2:1 randomisation)
Patients allowed concomitant use of ani-retrovirals, corticosteroids and interferons
Multicentre double-blind, randomised placebo-controlled trialClinical improvement
Adverse events
Intervention was not found to be liked to improvement (median 21 days vs 23 in placebo)
HR 1.23 (95% CI 0.87 to 1.75)
28-day mortality 14% vs 13%, difference 1.1% (95% CI −8.1 to 10.3)
66% patients in the intervention group displayed adverse events vs 64% in the control group
Potential confounders
Intervention seems to have been started relatively late
Underpowered as the study was terminated early