{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:23:45Z","timestamp":1790871825679,"version":"4.1.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T00:00:00Z","timestamp":1611705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Importance\/Background:<\/jats:bold> During current public health emergency of COVID-19 pandemic, repurposing of existing antiviral drugs may be an efficient strategy since there is no proven effective treatment. Published literature shows Remdesivir has broad-spectrum antiviral activity against numerous RNA viruses and has been recently recognized as a promising therapy against SARS-CoV-2.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A systematic search was conducted for full length manuscripts published between inception and July 19th, 2020 focussing on efficacy and safety of Remdesivir in COVID-19. The primary outcomes were defined as mortality rate and median days to recovery based on the available pooled data. The secondary outcome was adverse events rate and drug discontinuation rate.<\/jats:p><jats:p><jats:bold>Statistical Analysis:<\/jats:bold> All outcomes were performed using Comprehensive Meta-Analysis software package (Bio stat, Englewood, NJ, USA).<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> A total of 1,895 patients from 9 studies were included in this qualitative synthesis. In patients treated with Remdesivir, the mean recovery time was 15.84 days (95% CI 11.68\u201320, SE 2.12; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 97.24) and the pooled mortality rate was 11.3% (95% CI 7.9\u201316%; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 74.85). However, treatment with Remdesivir was associated with adverse effects (55.3%, 95% CI 31.5\u201376.9%; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 97.66) eventually warranting the discontinuation of the drug (17.8%, 95% CI 8.6\u201333.1%; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 95.64). The meta-analysis of three clinical trials indicated that administration of Remdesivir significantly reduces the mortality compared to the placebo (OR 0.70, 95% CI 0.58\u20130.84, <jats:italic>p<\/jats:italic> \u2264 0.001; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 16.6).<\/jats:p><jats:p><jats:bold>Conclusions and Relevance:<\/jats:bold> The result of contemporary meta-analysis suggests mortality benefit with Remdesivir in COVID-19 and median recovery time was over 2 weeks. The pooled mortality with Remdesivir was found to be very low, and this analysis can shed light on this potential treatment for COVID-19 patients.<\/jats:p>","DOI":"10.3389\/fmed.2020.606429","type":"journal-article","created":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T08:44:53Z","timestamp":1611737093000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":47,"title":["Mortality Benefit of Remdesivir in COVID-19: A Systematic Review and Meta-Analysis"],"prefix":"10.3389","volume":"7","author":[{"given":"Vikas","family":"Bansal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran S.","family":"Mahapure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Bhurwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishita","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar","family":"Hassanain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janaki","family":"Makadia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimisha","family":"Madas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige","family":"Armaly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romil","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishita","family":"Mehra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"O'Horo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Kashyap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,1,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1016\/j.mayocp.2020.02.003","article-title":"Guide to understanding the 2019 novel coronavirus","volume":"95","author":"Shah","year":"2020","journal-title":"Mayo Clin Proc."},{"key":"B2","doi-asserted-by":"publisher","first-page":"157","DOI":"10.23750\/abm.v91i1.9397","article-title":"WHO declares COVID-19 a pandemic","volume":"91","author":"Cucinotta","year":"2020","journal-title":"Acta Biomed."},{"key":"B3","unstructured":"GenevaReport of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/S1473-3099(20)30120-1","article-title":"An interactive web-based dashboard to track COVID-19 in real time","volume":"20","author":"Dong","year":"2020","journal-title":"Lancet Infect Dis."},{"key":"B5","unstructured":"RoserM\n            RitchieH\n            Ortiz-OspinaE\n            HasellJ\n          Our World in Data Web SiteCoronavirus Pandemic (COVID-19): Mortality Risk of COVID-19 - Statistics and Research2020"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2327","DOI":"10.1056\/NEJMc2015312","article-title":"Compassionate use of Remdesivir for patients with severe covid-19","volume":"382","author":"Grein","year":"2020","journal-title":"N Engl J Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"ofaa105","DOI":"10.1093\/ofid\/ofaa105","article-title":"Coronavirus disease 2019 treatment: a review of early and emerging options","volume":"7","author":"McCreary","year":"2020","journal-title":"Open Forum Infect Dis."},{"key":"B8","unstructured":"GenevaWorld Health Organization (WHO)WHOSolidarity\u201d Clinical Trial for COVID-19 Treatments2020"},{"key":"B9","unstructured":"Fact Sheet for Health Care Providers Emergency Use Authorization (EUA) of Remdesivir (GS-5734\u2122)2020"},{"key":"B10","doi-asserted-by":"publisher","first-page":"b2700","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration","volume":"339","author":"Liberati","year":"2009","journal-title":"BMJ."},{"key":"B11","unstructured":"BorensteinM\n            HedgesL\n            HigginsJ\n            RothsteinH\n          Englewood, NJBiostatComprehensive Meta-Analysis Version 32013"},{"key":"B12","doi-asserted-by":"crossref","first-page":"p. 241","DOI":"10.1002\/9781119536604.ch10","article-title":"Chapter 10: Analysing data and undertaking meta-analyses","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019)","author":"Deeks","year":"2019"},{"key":"B13","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1186\/1471-2288-14-135","article-title":"Estimating the sample mean and standard deviation from the sample size, median, range and\/or interquartile range","volume":"14","author":"Wan","year":"2014","journal-title":"BMC Med Res Methodol."},{"key":"B14","doi-asserted-by":"crossref","DOI":"10.1002\/9781119536604","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins","year":"2019"},{"key":"B15","doi-asserted-by":"crossref","first-page":"p. 349","DOI":"10.1002\/9781119536604.ch13","article-title":"Chapter 13: Assessing risk of bias due to missing results in a synthesis","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 6.0 (Updated July 2019)","author":"Page","year":"2019"},{"key":"B16","doi-asserted-by":"crossref","first-page":"p. 205","DOI":"10.1002\/9781119536604.ch8","article-title":"Chapter 8: Assessing risk of bias in a randomized trial","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019)","author":"Higgins","year":"2019"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2973","DOI":"10.1001\/jama.287.22.2973","article-title":"Correlation of quality measures with estimates of treatment effect in meta-analyses of randomized controlled trials","volume":"287","author":"Balk","year":"2002","journal-title":"JAMA."},{"key":"B18","unstructured":"Study Quality Assessment Tools"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1813","DOI":"10.1056\/NEJMoa2007764","article-title":"Remdesivir for the treatment of covid-19 - preliminary report","volume":"383","author":"Beigel","year":"2020","journal-title":"N Engl J Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1827","DOI":"10.1056\/NEJMoa2015301","article-title":"Remdesivir for 5 or 10 days in patients with severe covid-19","volume":"383","author":"Goldman","year":"2020","journal-title":"N Engl J Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1056\/NEJMoa2001191","article-title":"First case of 2019 novel coronavirus in the United States","volume":"382","author":"Holshue","year":"2020","journal-title":"N Engl J Med."},{"key":"B22","doi-asserted-by":"crossref","DOI":"10.1101\/2020.05.02.20088559","article-title":"Efficacy of Remdesivir in COVID-19 patients with a simulated two-arm controlled study","volume-title":"medRxiv [Preprint]","author":"Hsu","year":""},{"key":"B23","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1038\/s41591-020-0877-5","article-title":"Clinical and virologic characteristics of the first 12 patients with coronavirus disease 2019 (COVID-19) in the united states","volume":"26","author":"Kujawski","year":"2020","journal-title":"Nat Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1016\/S0140-6736(20)31022-9","article-title":"Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial","volume":"395","author":"Wang","year":"2020","journal-title":"Lancet."},{"key":"B25","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1002\/phar.2403","article-title":"Delayed initiation of Remdesivir in a COVID-19-positive patient","volume":"40","author":"Hillaker","year":"2020","journal-title":"Pharmacotherapy."},{"key":"B26","doi-asserted-by":"publisher","first-page":"104899","DOI":"10.1016\/j.phrs.2020.104899","article-title":"Compassionate Remdesivir treatment of severe covid-19 pneumonia in intensive care unit (ICU) and Non-ICU patients: clinical outcome and differences in post-treatment hospitalisation status","volume":"158","author":"Antinori","year":"2020","journal-title":"Pharmacol Res."},{"key":"B27","doi-asserted-by":"publisher","first-page":"8543","DOI":"10.4081\/idr.2020.8543","article-title":"National institute for the infectious diseases \u201cL. Spallanzani,\u201d IRCCS. Recommendations for COVID-19 clinical management","volume":"12","author":"Nicastri","year":"2020","journal-title":"Infect Dis Rep."},{"key":"B28","doi-asserted-by":"publisher","first-page":"104541","DOI":"10.1016\/j.antiviral.2019.104541","article-title":"Broad spectrum antiviral Remdesivir inhibits human endemic and zoonotic deltacoronaviruses with a highly divergent RNA dependent RNA polymerase","volume":"169","author":"Brown","year":"2019","journal-title":"Antiviral Res."},{"key":"B29","doi-asserted-by":"publisher","first-page":"eaal3653","DOI":"10.1126\/scitranslmed.aal3653","article-title":"Broad-spectrum antiviral GS-5734 inhibits both epidemic and zoonotic coronaviruses","volume":"9","author":"Sheahan","year":"2017","journal-title":"Sci Transl Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.vetmic.2018.04.026","article-title":"The nucleoside analog GS-441524 strongly inhibits feline infectious peritonitis (FIP) virus in tissue culture and experimental cat infection studies","volume":"219","author":"Murphy","year":"2018","journal-title":"Vet Microbiol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1038\/s41467-019-13940-6","article-title":"Comparative therapeutic efficacy of Remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV","volume":"11","author":"Sheahan","year":"2020","journal-title":"Nat Commun."},{"key":"B32","doi-asserted-by":"publisher","first-page":"6771","DOI":"10.1073\/pnas.1922083117","article-title":"Prophylactic and therapeutic Remdesivir (GS-5734) treatment in the rhesus macaque model of MERS-CoV infection","volume":"117","author":"de Wit","year":"2020","journal-title":"Proc Natl Acad Sci USA."},{"key":"B33","doi-asserted-by":"publisher","first-page":"e00221","DOI":"10.1128\/mBio.00221-18","article-title":"Coronavirus susceptibility to the antiviral Remdesivir (GS-5734) is mediated by the viral polymerase and the proofreading exoribonuclease","volume":"9","author":"Agostini","year":"2018","journal-title":"mBio."},{"key":"B34","doi-asserted-by":"publisher","first-page":"2293","DOI":"10.1056\/NEJMoa1910993","article-title":"A randomized, controlled trial of Ebola virus disease therapeutics","volume":"381","author":"Mulangu","year":"2019","journal-title":"N Engl J Med."},{"key":"B35","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1038\/nature17180","article-title":"Therapeutic efficacy of the small molecule GS-5734 against Ebola virus in rhesus monkeys","volume":"531","author":"Warren","year":"2016","journal-title":"Nature."},{"key":"B36","doi-asserted-by":"publisher","first-page":"eaau9242","DOI":"10.1126\/scitranslmed.aau9242","article-title":"Remdesivir (GS-5734) protects African green monkeys from Nipah virus challenge","volume":"11","author":"Lo","year":"2019","journal-title":"Sci Transl Med."},{"key":"B37","unstructured":"HerperM\n          Inside the NIH's Controversial Decision to Stop its Big Remdesivir Study2020"},{"key":"B38","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s40779-020-00240-0","article-title":"The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status","volume":"7","author":"Guo","year":"2020","journal-title":"Mil Med Res"},{"key":"B39","article-title":"Nucleoside Analogues","volume-title":"LiverTox: Clinical and Research Information on Drug-Induced Liver Injury","year":"2012"},{"key":"B40","doi-asserted-by":"publisher","first-page":"1680","DOI":"10.1016\/j.ajpath.2020.05.014","article-title":"Treatment of coronavirus disease 2019 (COVID-19) patients with convalescent plasma","volume":"190","author":"Salazar","year":"2020","journal-title":"Am J Pathol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"253","DOI":"10.2215\/CJN.01430307","article-title":"Systematic review and meta-analysis: when one study is just not enough","volume":"3","author":"Garg","year":"2008","journal-title":"Clin J Am Soc Nephrol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"e0113","DOI":"10.1097\/CCE.0000000000000113","article-title":"The viral infection and respiratory illness universal study (VIRUS): an international registry of coronavirus 2019-related critical illness","volume":"2","author":"Walkey","year":"2020","journal-title":"Crit Care Explor."},{"key":"B43","volume-title":"Clinical Management of Patients with Moderate to Severe COVID-19-Interim Guidance","author":"Tamblyn","year":"2020"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa478","article-title":"Infectious diseases society of America guidelines on the treatment and management of patients with COVID-19","author":"Bhimraj","year":"2020","journal-title":"Clin Infect Dis."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2020.606429\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T08:45:15Z","timestamp":1611737115000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2020.606429\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,27]]},"references-count":44,"alternative-id":["10.3389\/fmed.2020.606429"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2020.606429","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,27]]},"article-number":"606429"}}