Remdesivir for the treatment of patients hospitalized with COVID-19 receiving supplemental oxygen: a targeted literature review and meta-analysis

This network meta-analysis (NMA) assessed the efficacy of remdesivir in hospitalized patients with COVID-19 requiring supplemental oxygen. Randomized controlled trials of hospitalized patients with COVID-19, where patients were receiving supplemental oxygen at baseline and at least one arm received...

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Bibliographic Details
Published in:Scientific reports Vol. 12; no. 1; pp. 9622 - 11
Main Authors: Beckerman, Rachel, Gori, Andrea, Jeyakumar, Sushanth, Malin, Jakob J., Paredes, Roger, Póvoa, Pedro, Smith, Nathaniel J., Teixeira-Pinto, Armando
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 10.06.2022
Nature Publishing Group
Nature Portfolio
Subjects:
631/250/255/2514
692/308/409
Adenosine Monophosphate - analogs & derivatives
Adenosine Monophosphate - therapeutic use
Alanine - analogs & derivatives
Alanine - therapeutic use
Antiviral drugs
Clinical trials
Coronaviruses
COVID-19
COVID-19 Drug Treatment
Hospitalization
Humanities and Social Sciences
Humans
Literature reviews
Meta-analysis
Mortality
Mortality risk
multidisciplinary
Oxygen
Oxygen - therapeutic use
Patients
Randomized Controlled Trials as Topic
Science
Science (multidisciplinary)
Treatment Outcome
ISSN:2045-2322, 2045-2322
Online Access:Get full text
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Summary:This network meta-analysis (NMA) assessed the efficacy of remdesivir in hospitalized patients with COVID-19 requiring supplemental oxygen. Randomized controlled trials of hospitalized patients with COVID-19, where patients were receiving supplemental oxygen at baseline and at least one arm received treatment with remdesivir, were identified. Outcomes included mortality, recovery, and no longer requiring supplemental oxygen. NMAs were performed for low-flow oxygen (LFO 2 ); high-flow oxygen (HFO 2 ), including NIV (non-invasive ventilation); or oxygen at any flow (AnyO 2 ) at early (day 14/15) and late (day 28/29) time points. Six studies were included (N = 5245 patients) in the NMA. Remdesivir lowered early and late mortality among AnyO 2 patients (risk ratio (RR) 0.52, 95% credible interval (CrI) 0.34–0.79; RR 0.81, 95%CrI 0.69–0.95) and LFO 2 patients (RR 0.21, 95%CrI 0.09–0.46; RR 0.24, 95%CrI 0.11–0.48); no improvement was observed among HFO 2 patients. Improved early and late recovery was observed among LFO 2 patients (RR 1.22, 95%CrI 1.09–1.38; RR 1.17, 95%CrI 1.09–1.28). Remdesivir also lowered the requirement for oxygen support among all patient subgroups. Among hospitalized patients with COVID-19 requiring supplemental oxygen at baseline, use of remdesivir compared to best supportive care is likely to improve the risk of mortality, recovery and need for oxygen support in AnyO 2 and LFO 2 patients.
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ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-022-13680-6