Remdesivir for the treatment of COVID-19 disease: A retrospective comparative study of patients treated with and without Remdesivir

7/19 Late treatment study

Madan et al., medRxiv, doi:10.1101/2021.07.15.21260600 (Preprint)
Remdesivir for the treatment of COVID-19 disease: A retrospective comparative study of patients treated with and without Remdesivir

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Retrospective 1,262 hospitalized patients, 398 treated with remdesivir, showing unadjusted lower mortality with treatment, and a treatment delay-response relationship.

Madan et al., 7/19/2021, retrospective, India, South Asia, preprint, 22 authors.

risk of death, 44.4% lower, RR 0.56, p = 0.03, treatment 23 of 398 (5.8%), control 27 of 260 (10.4%), unadjusted.

risk of death, 65.6% lower, RR 0.34, p = 0.04, treatment 4 of 112 (3.6%), control 27 of 260 (10.4%), unadjusted, <5 days from onset.

risk of death, 61.7% lower, RR 0.38, p = 0.009, treatment 9 of 226 (4.0%), control 27 of 260 (10.4%), unadjusted, 5-10 days from onset.

risk of death, 60.5% higher, RR 1.60, p = 0.18, treatment 10 of 60 (16.7%), control 27 of 260 (10.4%), unadjusted, >10 days from onset.

This study is excluded in meta analysis: excessive unadjusted differences between groups.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. For an individual study the most serious outcome may have a smaller number of events and lower statistical signficance, however this provides the strongest evidence for the most serious outcomes when combining the results of many trials.

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