Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.11.19.20234153; this version posted November 20, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission. Title: Effectiveness of remdesivir with and without dexamethasone in hospitalized patients with COVID-19 Brian T. Garibaldi MD MEHP1*, Kunbo Wang MS2*, Matthew L. Robinson MD3, Scott L. Zeger PhD4, Karen Bandeen Roche PhD4, Mei-Cheng Wang PhD4, G. Caleb Alexander MD5, Amita Gupta MD3, Robert Bollinger MD MPH3, Yanxun Xu PhD2,6 1 Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD 2 Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD USA 3 Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD USA 4 Division of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA 5 Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA 6 Division of Biostatistics and Bioinformatics at The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD USA * Dr. Garibaldi and Mr. Wang contributed equally to this article. * Dr. Garibaldi and Mr. Wang contributed equally to this article. BTG, KW, YX contributed to the conception and design of the work, the acquisition, analysis, and interpretation of data MR, SZ, KBR, MCW, CA, AG, RB contributed to the conception and design of the work and interpretation of the data. All authors contributed to the drafting and revising of the manuscript for important intellectual content, give final approval of the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Corresponding Author Brian T. Garibaldi, MD MEHP Division of Pulmonary and Critical Care Medicine Johns Hopkins University School of Medicine 1830 East Monument Street Baltimore, MD 21205 (443) 804-8286 Bgariba1@jhmi.edu Funding and Support: JH-CROWN received funding from Hopkins inHealth, the Johns Hopkins Precision Medicine Program. BTG, KW, MR, AG and YX received funding from the COVID-19 Administrative Supplement for the HHS Region 3 Treatment Center from the Office of the Assistant Secretary for Preparedness and Response. 1 NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: https://doi.org/10.1101/2020.11.19.20234153; this version posted November 20, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission. ABSTRACT Rationale: Remdesivir and dexamethasone reduced the severity of COVID-19 in clinical trials. However, their individual or combined effectiveness in clinical practice remains unknown. Objectives: To examine the effectiveness of remdesivir with or without dexamethasone. Methods: We conducted a multicenter, retrospective cohort study between March 4 and August 29, 2020. Eligible COVID cases were hospitalized patients treated with..