Remdesivir Efficacy in COVID-19 Treatment: A Randomized Controlled Trial

• Published in: The American journal of tropical medicine and hygiene 2022-03, Vol.106 (3), p.886-890
• Main Authors: Abd-Elsalam, Sherief, Salama, Marwa, Soliman, Shaimaa, Naguib, Ahmed Mohamed, Ibrahim, Ibrahim S, Torky, Mohamed, El Ghafar, Mohamed Samir Abd, Abdul-Baki, Enas Abdul-Raouf M, Elhendawy, Mohammed
• Format: Article
• Language: English
• Subjects: Adenosine Monophosphate - analogs & derivatives; Alanine - analogs & derivatives; Antiviral Agents - therapeutic use; Antiviral drugs; Coronaviruses; COVID-19; COVID-19 - drug therapy; Humans; Length of stay; Mortality; SARS-CoV-2; Treatment Outcome; Ventilation
• ISSN: 0002-9637; 1476-1645
• DOI: 10.4269/ajtmh.21-0606

To date, no antiviral therapy has shown proven clinical effectiveness in treating patients with COVID-19. We assessed the efficacy of remdesivir in hospitalized Egyptian patients with COVID-19. Patients were randomly assigned at a 1:1 ratio to receive either remdesivir (200 mg on the first day followed by 100 mg daily for the next 9 days intravenously infused over 30-60 minutes) in addition to standard care or standard care alone. The primary outcomes were the length of hospital stay and mortality rate. The need for mechanical ventilation was assessed as a secondary outcome. Two hundred patients (100 in each group) completed the study and were included in the final analysis. The remdesivir group showed a significantly lower median duration of hospital stay (10 days) than the control group (16 days; P < 0.001). Eleven of the patients in the remdesivir group needed mechanical ventilation compared with eight patients in the control group (P = 0.469). The mortality rate was comparable between the two groups (P = 0.602). Mortality was significantly associated with older age, elevated C-reactive protein levels, elevated D-dimer, and the need for mechanical ventilation (P = 0.039, 0.003, 0.001, and