Reddy Vegivinti Charan Thej, Pederson John M, Saravu Kavitha, Gupta Nitin, Barrett Averi, Davis Amber R, Kallmes Kevin M, Evanson Kirk W
Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.
Nested Knowledge, St. Paul, MN, USA.
Ann Med Surg (Lond). 2021 Jan 6;62:43-48. doi: 10.1016/j.amsu.2020.12.051. eCollection 2021 Feb.
To perform a systematic review and meta-analysis of randomized controlled trials that examined remdesivir treatment for COVID-19.
A systematic literature search was performed using Pubmed, Embase, and ClinicalTrials.gov to identify studies published up to October 25, 2020 that examined COVID-19 treatment with remdesivir. A total of 3 randomized controlled trials that consisted of 1691 patients were included in the meta-analysis.
The odds for mechanical ventilation (MV) or extracorporeal membrane oxygenation (ECMO) following treatment was significantly lower in the remdesivir group compared to the control group (OR = 0.48 [95% CI: 0.34; 0.69], < 0.001). The odds of early (at day 14/15; OR = 1.42 [95% CI: 1.16; 1.74], < 0.001) and late (at day 28/29; OR = 1.44 [95% CI: 1.16; 1.79], = 0.001) hospital discharge were significantly higher in the remdesivir group compared to the control group. There was no difference in the odds for mortality in patients treated with remdesivir (OR = 0.77 [95% CI: 0.56; 1.06], = 0.108).
Remdesivir attenuates disease progression, leading to lower odds of MV/ECMO and greater odds of hospital discharge for COVID-19 patients. However, remdesivir does not affect odds of mortality.
对考察瑞德西韦治疗新型冠状病毒肺炎（COVID-19）的随机对照试验进行系统评价和荟萃分析。
利用PubMed、Embase和ClinicalTrials.gov进行系统文献检索，以识别截至2020年10月25日发表的考察瑞德西韦治疗COVID-19的研究。共有3项包含1691例患者的随机对照试验纳入荟萃分析。
与对照组相比，瑞德西韦组治疗后接受机械通气（MV）或体外膜肺氧合（ECMO）的几率显著降低（比值比[OR]=0.48[95%置信区间（CI）：0.34；0.69]，P<0.001）。与对照组相比，瑞德西韦组早期（第14/15天；OR=1.42[95%CI：1.16；1.74]，P<0.001）和晚期（第28/29天；OR=1.44[95%CI：1.16；1.79]，P=0.001）出院的几率显著更高。接受瑞德西韦治疗的患者死亡几率无差异（OR=0.77[95%CI：0.56；1.06]，P=0.108）。
瑞德西韦可减轻疾病进展，降低COVID-19患者接受MV/ECMO的几率，并增加出院几率。然而，瑞德西韦不影响死亡几率。
