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Other Treatments Global Adoption
 
Remdesivir COVID-19 studies. Studies show significantly increased risk of acute kidney injury. Recent:
Zhou
Delandre.
Remdesivir has been officially adopted for early treatment in all or part of 10 countries. Submit updates/corrections.
May 13
Late Zangeneh et al., Obesity Medicine, doi:10.1016/j.obmed.2022.100420
death, ↓32.0%, p=0.06
Survival analysis based on body mass index in patients with Covid-19 admitted to the intensive care unit of Amir Al-Momenin Hospital in Arak – 2021
Details   Retrospective 193 ICU patients in Iran, showing lower mortality with remdesivir treatment, not reaching statistical significance.
Apr 2
In Vitro Delandre et al., Pharmaceuticals, doi:10.3390/ph15040445 (In Vitro)
In Vitro
Antiviral Activity of Repurposing Ivermectin against a Panel of 30 Clinical SARS-CoV-2 Strains Belonging to 14 Variants
Details   In Vitro study with 30 COVID-19 strains from 14 variants, showing stronger efficacy with ivermectin compared to CQ and remdesivir, and relatively homogeneous efficacy with ivermectin regardless of strain/variant, in contrast to results fo..
Mar 17
N/A Zhou et al., Frontiers in Pharmacology, doi:10.3389/fphar.2022.833679 Acute Kidney Injury and Drugs Prescribed for COVID-19 in Diabetes Patients: A Real-World Disproportionality Analysis
Details   FAERS analysis showing significantly increased risk of acute kidney injury with remdesivir.
Mar 14
Late Elec et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.03.015
death, ↓19.3%, p=0.66
COVID-19 and Kidney Transplantation: The impact of remdesivir on renal function and outcome - a retrospective cohort study
Details   Retrospective 165 hospitalized COVID-19+ kidney transplant patients, 38 treated with remdesivir, showing no significant difference in mortality, higher ICU admission, and lower ICU mortality. Subject to confounding by time with significan..
Mar 11
Late Salehi et al., Research Square, doi:10.21203/rs.3.rs-1362678/v1 (Preprint)
death, ↓36.6%, p=0.01
Risk factors of death in mechanically ventilated COVID-19 patients: a retrospective multi-center study
Details   Retrospective 125 mechanically ventilated ICU patients in Iran, showing lower mortality with remdesivir treatment in unadjusted results.
Feb 28
Late Siraj et al., Indian Journal of Clinical Practice, 32:9
death, ↓52.9%, p<0.0001
Efficacy of Various Treatment Modalities on Patient-related Outcome in Hospitalized COVID-19 Patients – A Retrospective Study
Details   Retrospective 1,000 COVID+ hospitalized patients in India, showing lower mortality with famotidine and remdesivir in multivariable logistic regression.
Feb 28
Late Kurniyanto et al., Journal of Clinical Virology Plus, doi:10.1016/j.jcvp.2022.100068
death, ↑460.0%, p=0.0009
Factors Associated with Death and ICU Referral among COVID-19 Patients Hospitalized in the Secondary Referral Academic Hospital in East Jakarta, Indonesia
Details   Retrospective 477 hospitalized patients in Indonesia, showing higher mortality with remdesivir in unadjusted results.
Dec 30
2021
Animal Vermillion et al., Science Translational Medicine, doi:10.1126/scitranslmed.abl8282
animal study
Inhaled remdesivir reduces viral burden in a nonhuman primate model of SARS-CoV-2 infection
Details   African green monkey study of inhaled versus IV remdesivir, showing similar efficacy with inhalation. Comparable concentrations of the active triphosphate in the lower respiratory tract were found with ~20x lower dose using inhalation, an..
Dec 29
2021
Late Mustafa et al., Exploratory Research in Clinical and Social Pharmacy, doi:10.1016/j.rcsop.2021.100101
death, ↓32.7%, p=0.21
Pattern of medication utilization in hospitalized patients with COVID-19 in three District Headquarters Hospitals in the Punjab province of Pakistan
Details   Retrospective 444 hospitalized patients in Pakistan, showing lower mortality with remdesivir treatment in unadjusted results, not reaching statistical significance.
Dec 22
2021
Early Gottlieb et al., New England Journal of Medicine, doi:10.1056/NEJMoa2116846
death/hosp., ↓87.0%, p=0.008
Early Remdesivir to Prevent Progression to Severe Covid-19 in Outpatients
Details   RCT high-risk outpatients, 279 treated with remdesivir and 283 control patients, median 5 days from symptoms, showing significantly lower hospitalization with treatment. NCT04501952.
Dec 13
2021
Late Jamir et al., Cureus, doi:10.7759/cureus.20394
death, ↓8.0%, p=0.77
Determinants of Outcome Among Critically Ill Police Personnel With COVID-19: A Retrospective Observational Study From Andhra Pradesh, India
Details   Retrospective 266 COVID-19 ICU patients in India, showing significantly lower mortality with PVP-I oral gargling and topical nasal use, and non-statistically significant higher mortality with ivermectin and lower mortality with remdesivir.
Nov 12
2021
Late Schmidt et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.34330
severe case, ↑509.0%, p<0.0001
Association Between Androgen Deprivation Therapy and Mortality Among Patients With Prostate Cancer and COVID-19
Details   Retrospective 1,106 prostate cancer patients, showing higher mortality with remdesivir treatment.
Oct 1
2021
Late Mozaffari et al., Clinical Infectious Diseases, doi:10.1093/cid/ciab875
death, ↓12.0%, p=0.003
Remdesivir treatment in hospitalized patients with COVID-19: a comparative analysis of in-hospital all-cause mortality in a large multi-center observational cohort
Details   Retrospective 28,855 remdesivir patients with PSM matched controls, showing lower mortality with treatment.
Sep 14
2021
Late Ader et al., Lancet Infectious Diseases, doi:10.1016/S1473-3099(21)00485-0
death, ↓6.4%, p=0.77
Remdesivir plus standard of care versus standard of care alone for the treatment of patients admitted to hospital with COVID-19 (DisCoVeRy): a phase 3, randomised, controlled, open-label trial
Details   RCT 857 hospitalized patients, showing no significant differences with remdesivir treatment. DISCOVERY trial. EudraCT2020-000936-23, NCT04315948.
Aug 19
2021
Late Diaz et al., Clinical Infectious Diseases, doi:10.1093/cid/ciab698
death, ↓34.7%, p=0.01
Remdesivir and Mortality in Patients with COVID-19
Details   Retrospective 1138 hospitalized patients in the USA, 286 treated with remdesivir, showing lower mortality with treatment.
Aug 16
2021
Late Eldeen et al., Microbes and Infectious Diseases, doi:10.21608/mid.2021.85877.1177 Comparative study between the therapeutic effect of remdesivir versus hydroxychloroquine in COVID-19 hospitalized patients
Details   Small study comparing 25 HCQ and 25 remdesivir hospitalized patients, reporting faster viral clearance with remdesivir. The article proof is missing the results for the HCQ group. Confounding by time is likely - remdesivir patients were a..
Aug 13
2021
Late Hosseini et al., medRxiv, doi:10.1101/2021.08.13.21261992 (Preprint) Another step toward final call on Remdesivir efficacy as a treatment for hospitalized COVID-19 patients: a multicenter open-label trial
Details   Single arm remdesivir trial with 145 hospitalized patients showing no statistically significant difference between "early" and "late" administration, however the treatment delays may be better described as late and ver..
Aug 9
2021
Late Kuno et al., Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkab256
death, ↓0.9%, p=0.96
The association of remdesivir and in-hospital outcomes for COVID-19 patients treated with steroids
Details   PSM retrospective 3,372 hospitalized patients in the USA treated with steroids, showing no significant difference in mortality with remdesivir, but a lower risk of acute kidney injury.
Aug 5
2021
Meta Anseems et al., Cochrane Database of Systematic Reviews, doi:10.1002/14651858.CD014962 (Preprint) (meta analysis)
meta-analysis
Remdesivir for the treatment of COVID‐19
Details   Review of 5 RCTs prior to April 17, 2021 showing mortality RR 0.93 [0.81-1.06] for hospitalized patients.
Jul 19
2021
Late Madan et al., medRxiv, doi:10.1101/2021.07.15.21260600 (Preprint)
death, ↓44.4%, p=0.03
Remdesivir for the treatment of COVID-19 disease: A retrospective comparative study of patients treated with and without Remdesivir
Details   Retrospective 1,262 hospitalized patients, 398 treated with remdesivir, showing unadjusted lower mortality with treatment, and a treatment delay-response relationship.
Jul 15
2021
Late Ohl et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.14741
death, ↑6.0%, p=0.66
Association of Remdesivir Treatment With Survival and Length of Hospital Stay Among US Veterans Hospitalized With COVID-19
Details   Retrospective 5,898 hospitalized patients in the USA, 2,374 receiving remdesivir treatment, showing no significant difference in mortality, and a longer time to hospital discharge with treatment.
Jul 13
2021
Late Barrat-Due et al., Annals of Internal Medicine, doi:10.7326/M21-0653
death, 0.0%, p=1.00
Evaluation of the Effects of Remdesivir and Hydroxychloroquine on Viral Clearance in COVID-19
Details   Small RCT in Norway with 52 HCQ and 42 remdesivir patients, showing no significant differences with treatment. Add-on trial to WHO Solidarity. NCT04321616.
Jun 21
2021
Late Arch et al., medRxiv, doi:10.1101/2021.06.18.21259072 (Preprint)
death, ↓19.9%, p=0.03
Evaluation of the effectiveness of remdesivir in treating severe COVID-19 using data from the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, national cohort study
Details   Prospective PSM analysis of remdesivir use in the UK showing statistically significantly lower mortality at 28 days. For unspecified reasons, the study prioritized short-term outcomes. Mortality at 14 days was also lower but not statistic..
May 26
2021
Late Pourhoseingholi et al., Research Square, doi:10.21203/rs.3.rs-365321/v2 (Preprint)
death, ↑2.0%, p=0.92
Case Characteristics, Clinical Data, And Outcomes of Hospitalized COVID-19 Patients In Qom Province, Iran: A Prospective Cohort Study
Details   Prospective study of 2,468 hospitalized COVID-19 patients in Iran, showing no significant difference with remdesivir treatment. IR.MUQ.REC.1399.013.
May 4
2021
Meta Liao et al., Journal of the Formosan Medical Association, doi:10.1016/j.jfma.2021.04.026 (meta analysis)
meta-analysis
Assessing Efficacy of Antiviral Therapy for COVID-19 Patients: A Case Study on Remdesivir with Bayesian Synthesis Design and Multistate Analysis
Details   Bayesian synthesis design and multistate analysis of remdesivir results showing 31% [18-44%] lower risk of death and 10% [1-18%] higher recovery.
Apr 30
2021
Late Elhadi et al., PLOS ONE, doi:10.1371/journal.pone.0251085
death, ↑10.9%, p=0.65
Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study
Details   Prospective study of 465 COVID-19 ICU patients in Libya showing no significant differences with treatment.
Apr 29
2021
Late Aghajani et al., Journal of Medical Virology, doi:10.1002/jmv.27053
death, ↓18.6%, p=0.49
Decreased In-Hospital Mortality Associated with Aspirin Administration in Hospitalized Patients Due to Severe COVID-19
Details   Retrospective 991 hospitalized patients in Iran focusing on aspirin use but also showing results for HCQ, remdesivir, and favipiravir.
Apr 7
2021
Late Mulhem et al., BMJ Open, doi:10.1136/bmjopen-2020-042042
death, ↑85.7%, p=0.54
3219 hospitalised patients with COVID-19 in Southeast Michigan: a retrospective case cohort study
Details   Retrospective database analysis of 3,219 hospitalized patients in the USA. Very different results in the time period analysis (Table S2), and results significantly different to other studies for the same medications (e.g., heparin OR 3.06..
Mar 20
2021
Late Mahajan et al., Indian Journal of Anasthesia, doi:10.4103/ija.IJA_149_21
death, ↑76.5%, p=0.47
Clinical outcomes of using remdesivir in patients with moderate to severe COVID-19: A prospective randomised study
Details   Small RCT with 34 remdesivir patients and 36 controls finding no significant difference in clinical outcomes.
Mar 10
2021
Late Tsuzuki et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.02.039 (preprint 3/10/2021)
death, ↑4.0%, p=0.21
Efficacy of remdesivir in hospitalized nonsevere COVID-19 patients in Japan: A large observational study using the COVID-19 Registry Japan
Details   Retrospective database analysis of 12,487 hospitalized patients in Japan, showing lower risk of oxygen requirement, but no significant difference in mortality or ventilation/ECMO.
Mar 9
2021
Late Goldberg et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2021.02.029
hosp. time, ↓9.2%, p=0.77
A real-life setting evaluation of the effect of remdesivir on viral load in COVID-19 patients admitted to a large tertiary center in Israel
Details   Retrospective 29 remdesivir patients and 113 controls, not finding a significant difference in nasopharyngeal viral load or hospitalization time. Hospitalization time was lower with treatment, with a larger reduction for non-intubated pat..
Mar 8
2021
Late Fateh et al., medRxiv, doi:10.1101/2021.03.05.21251351 (Preprint) A single-center retrospective cohort study of Covid-19 medications: Remdesivir, Favipiravir, Methylprednisolone, Dexamethasone, and Interferon β1a and their combinations
Details   Retrospective 324 hospitalized patients in Iran reporting on the use remdesivir, favipiravir, methylprednisolone, dexamethasone, and interferon β1a and their combinations. There is no control group in this study, however authors suggest t..
Feb 28
2021
Late Yeramaneni et al., Gastroenterology, doi:10.1053/j.gastro.2020.10.011
death, ↑24.0%, p=0.87
Famotidine Use Is Not Associated With 30-day Mortality: A Coarsened Exact Match Study in 7158 Hospitalized Patients With Coronavirus Disease 2019 From a Large Healthcare System
Details   Retrospective 7,158 hospitalized COVID-19 patients in the USA, showing no significant difference in mortality with remdesivir treatment.
Feb 27
2021
Safety Touafchia et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2021.02.013
safety analysis
Serious bradycardia and remdesivir for coronavirus 2019 (COVID-19): a new safety concerns
Details   Comparison of bradycardia in COVID-19 patients treated with remdesivir compared to those treated with HCQ, lopinavir/ritonavir, tocilizumab or glucocorticoids, finding increased risk of bradycardia with remdesivir.
Dec 28
2020
N/A Shen et al., Fundamentals of Clinical Pharmacology, doi:10.1111/fcp.12643
safety analysis
Remdesivir potently inhibits carboxylesterase‐2 through covalent modifications: signifying strong drug‐drug interactions
Details   Analysis finding that remdesivir at nanomolar concentrations inhibits carboxylesterase‐2 (CES2) through covalent modifications. CES2 is a major drug‐metabolizing enzyme. Authors conclude that caution must be exercised when remdesivir is u..
Dec 24
2020
In Vitro Jeffreys et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2022.106542 (preprint 12/24/2020) (In Vitro)
In Vitro
Remdesivir-ivermectin combination displays synergistic interaction with improved in vitro activity against SARS-CoV-2
Details   In Vitro study showing enhanced antiviral activity of ivermectin and remdesivir in combination.
Dec 19
2020
Late Gérard et al., Clinical Pharmacology & Therapeutics, doi:10.1002/cpt.2145 Remdesivir and Acute Renal Failure: A Potential Safety Signal From Disproportionality Analysis of the WHO Safety Database
Details   VigiBase retrospective showing a 20x increase in the risk of acute renal failure with remdesivir.
Nov 29
2020
Late Ullah et al., International Journal of Sciences, doi:10.18483/ijSci.2417
death, ↑100%, p=0.33
Efficacy of Remdesivir in Covid-19 Patients; Multicenter Study in Lahore
Details   Small late stage (hospitalized, <12 days symptoms) remdesivir study showing non-statistically significant higher mortality with treatment. No adjustments were made for differences in the groups. Remdesivir mean age was 49 vs. control 57. ..
Nov 20
2020
Late Garibaldi et al., medRxiv, doi:10.1101/2020.11.19.20234153 (Preprint)
death, ↓20.0%, p=0.44
Effectiveness of remdesivir with and without dexamethasone in hospitalized patients with COVID-19
Details   Retrospective 303 remdesivir patients and 303 matched controls showing significantly faster clinical improvement, and lower (but not statistically significant) mortality.
Nov 3
2020
Late Flisiak et al., medRxiv, doi:10.1101/2020.10.30.20215301 (Preprint)
death, ↓48.9%, p=0.18
Remdesivir-based therapy improved recovery of patients with COVID-19 in the SARSTer multicentre, real-world study
Details   Retrospective study comparing 122 remdesivir patients and 211 lopinavir/ritonavir patients, showing higher rates of clinical improvement with remdesivir and lower mortality (not statistically significant).
Oct 20
2020
Late Solh et al., medRxiv, doi:10.1101/2020.10.16.20214130 (Preprint)
death, ↓47.0%, p<0.001
Clinical course and outcome of COVID-19 acute respiratory distress syndrome: data from a national repository
Details   Retrospective database analysis of 7,816 Veterans Affairs hospitalized patients showing 47% reduction in progression from ARDS to mortality.
Oct 15
2020
Late SOLIDARITY Trial Consortium, NEJM, doi:10.1056/NEJMoa2023184 (preprint 10/15)
death, ↓5.0%, p=0.53
Repurposed antiviral drugs for COVID-19; interim WHO SOLIDARITY trial results
Details   WHO SOLIDARITY open-label RCT with 2,750 very late stage (76% on oxygen/ventilation) remdesivir patients, mortality relative risk RR 0.95 [0.81-1.11], p=0.50. Non-ventilated patients show a greater benefit, RR 0.86 [0.72-1.04], p = 0.13.
Oct 8
2020
Late Beigel et al., NEJM, doi:10.1056/NEJMoa2007764
death, ↓27.0%, p=0.07
Remdesivir for the Treatment of Covid-19 — Final Report
Details   RCT 1,062 hospitalized patients showing faster recovery time with treatment, median 10 days vs. 15 days for placebo, rate ratio for recovery 1.29, p<0.001. Day 29 mortality was 11.4% with remdesivir and 15.2% with placebo, hazard ratio HR..
Aug 28
2020
Late Fried et al., Clinical Infectious Disease, doi:10.1093/cid/ciaa1268
death, ↓61.2%, p=0.02
Patient Characteristics and Outcomes of 11,721 Patients with COVID19 Hospitalized Across the United States
Details   Database analysis of 11,721 hospitalized patients, 48 treated with remdesivir. Data inconsistencies have been found in this study, for example 99.4% of patients treated with HCQ were treated in urban hospitals, compared to 65% of untreate..
Aug 23
2020
Late Pasquini et al., Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkaa321
death, ↓16.2%, p=0.03
Effectiveness of remdesivir in patients with COVID-19 under mechanical ventilation in an Italian ICU
Details   Retrospective 51 ICU patients under mechanical ventilation, 25 treated with remdesivir, showing lower mortality with treatment.
Aug 21
2020
Late Spinner et al., JAMA, doi:10.1001/jama.2020.16349
death, ↓34.9%, p=0.50
Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderate COVID-19A Randomized Clinical Trial
Details   Late stage (median 8 days from symptom onset) RCT 584 patients with moderate COVID-19 showing (non-statistically significant) lower mortality. 5-day remdesivir had significantly higher odds of a better clinical status distribution on the ..
Jul 24
2020
Late Olender et al., Clinical Infectious Diseases, doi:10.1093/cid/ciaa1041
death, ↓58.8%, p=0.001
Remdesivir for Severe Coronavirus Disease 2019 (COVID-19) Versus a Cohort Receiving Standard of Care
Details   Comparative analysis between remdesivir trial GS-US-540–5773 and a retrospective SOC cohort with similar inclusion criteria, showing lower mortality and higher recovery at day 14 with remdesivir.
Jun 30
2020
Late Dubert et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.06.093 Case report study of the first five COVID-19 patients treated with remdesivir in France
Details   Early report on 5 ICU patients treated with remdesivir highlighting issues with usage in critically ill patients.
Jun 29
2020
Late Zhu et al., medRxiv, doi:10.1101/2020.06.22.20136531 (Preprint) (meta analysis)
death, ↓36.0%, p=0.02
Efficacy and Safety of Remdesivir for COVID-19 Treatment: An Analysis of Randomized, Double-Blind, Placebo-Controlled Trials
Details   Meta analysis of Beigel and Wang RCTs showing remdesivir significantly decreased mortality (8.18% vs. 12.70%, RR 0.64 [0.44-0.92], p = 0.175).
May 27
2020
Late Goldman et al., NEJM, doi:10.1056/NEJMoa2015301 Remdesivir for 5 or 10 Days in Patients with Severe Covid-19
Details   RCT of remdesivir for 5 or 10 days with no placebo control group, showing no significant differences between 5 and 10 day treatment. NCT04292899.
Apr 29
2020
Late Wang et al., Lancet, doi:10.1016/S0140-6736(20)31022-9
death, ↑8.6%, p=1.00
Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial
Details   Small RCT with 237 hospitalized patients in China with severe COVID-19, not showing statistically significant benefits. 158 treatment patients and 79 control patients. While too small for significance, the subgroup treated within 10 days ..
Apr 10
2020
Late Grein et al., NEJM, doi:10.1056/NEJMoa2007016 Compassionate Use of Remdesivir for Patients with Severe Covid-19
Details   Report on compassionate use of remdesivir with 61 severe COVID-19 patients, showing clinical improvement in 36 of 53 patients.
Please send us corrections, updates, or comments. Vaccines and treatments are both valuable and complementary. All practical, effective, and safe means should be used. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases mortality, morbidity, collateral damage, and the risk of endemic status. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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