Remdesivir Efficacy in COVID-19 Treatment: A Randomized Controlled Trial
Sherief Abd-Elsalam, Ossama Ashraf Ahmed, Noha O Mansour, Doaa H Abdelaziz, Marwa Salama, Mohamed Hassan Ahmed Fouad, Shaimaa Soliman, Ahmed Mohamed Naguib, Mohamed Sayed Hantera, Ibrahim S Ibrahim, Mohamed Torky, Hany M Dabbous, Mohamed Samir Abd El Ghafar, Enas A Abdul-Baki, Mohammed Elhendawy
The American Journal of Tropical Medicine and Hygiene, 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 5 0.469). The mortality rate was comparable between the two groups (P 5 0.602). Mortality was significantly associated with older age, elevated C-reactive protein levels, elevated D-dimer, and the need for mechanical ventilation (P 5 0.039, 0.003, 0.001, and , 0.001 respectively). Remdesivir had a positive influence on length of hospital stay, but it had no mortality benefit in Egyptian patients with COVID-19. Its use, in addition to standard care including dexamethasone, should be considered, particularly in low-and middle-income countries when other effective options are scarce.
R E T R A C T E D
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