Key Laboratory of Tropical Translational Medicine of Ministry of Education, NHC Key Laboratory of Tropical Disease Control, School of Tropical Medicine and The Second Affiliated Hospital, Hainan Medical University, Haikou, China.
Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China.
BMC Infect Dis. 2023 Oct 9;23(1):672. doi: 10.1186/s12879-023-08525-0.
Remdesivir is considered to be a specific drug for treating coronavirus disease 2019. This systematic review aims to evaluate the clinical efficacy and risk of remdesivir alone and in combination with other drugs.
The PubMed, Embase, SCIE, Cochrane Library, and American Clinical trial Center databases were searched up to 1 April 2022 to identify. Randomized controlled trials (RCTs) and observational studies comparing the efficacy of remdesivir monotherapy and combination therapy with that of control drugs.
Ten RCTs and 32 observational studies were included in the analysis. Regarding the primary outcome, remdesivir use reduced mortality in patients with severe COVID-19 (RR = 0.57, 95% CI (0.48,0.68)) and shortened the time to clinical improvement (MD = -2.51, 95% CI (-2.75, -2.28)). Regarding other clinical outcomes, remdesivir use was associated with improved clinical status (RR = 1.08, 95%CI (1.01, 1.17)). Regarding safety outcomes, remdesivir use did not cause liver or kidney damage (RR = 0.87, 95%CI (0.68, 1.11)) (RR = 0.88, 95%CI (0.70,1.10)). Compared with remdesivir alone, remdesivir combined with other drugs (e.g., steroids, favipiravir, and convalescent plasma) had no effect on mortality.
The use of remdesivir can help to reduce the mortality of patients with severe COVID-19 and shorten the time to clinical improvement. There was no benefit of remdesivir combination therapy for other clinical outcomes.
PROSPERO registration number: CRD42022322859.
瑞德西韦被认为是治疗 2019 年冠状病毒病的特效药物。本系统评价旨在评估瑞德西韦单药治疗和联合其他药物治疗的临床疗效和风险。
检索 PubMed、Embase、SCIE、Cochrane 图书馆和美国临床试验中心数据库，截至 2022 年 4 月 1 日，以确定比较瑞德西韦单药治疗和联合治疗与对照药物疗效的随机对照试验（RCT）和观察性研究。
纳入 10 项 RCT 和 32 项观察性研究进行分析。关于主要结局，瑞德西韦治疗可降低重症 COVID-19 患者的死亡率（RR=0.57，95%CI（0.48，0.68）），缩短临床改善时间（MD=-2.51，95%CI（-2.75，-2.28））。关于其他临床结局，瑞德西韦治疗与改善临床状况相关（RR=1.08，95%CI（1.01，1.17））。关于安全性结局，瑞德西韦治疗不会导致肝或肾损伤（RR=0.87，95%CI（0.68，1.11））（RR=0.88，95%CI（0.70，1.10））。与瑞德西韦单药治疗相比，瑞德西韦联合其他药物（如皮质类固醇、法匹拉韦和恢复期血浆）对死亡率无影响。
使用瑞德西韦可以帮助降低重症 COVID-19 患者的死亡率，并缩短临床改善时间。瑞德西韦联合治疗对其他临床结局没有获益。
PROSPERO 注册号：CRD42022322859。
