Clinical outcomes of using remdesivir in patients with moderate to severe COVID-19: A prospective randomised study
Mahajan et al.
, Clinical outcomes of using remdesivir in patients with moderate to severe COVID-19: A prospective randomised..
, Indian Journal of Anasthesia, doi:10.4103/ija.IJA_149_21
Small RCT with 34 remdesivir patients and 36 controls finding no significant difference in clinical outcomes.[Gérard, Zhou]
show significantly increased risk of acute kidney injury with remdesivir.
risk of death, 76.5% higher, RR 1.76, p = 0.47, treatment 5 of 34 (14.7%), control 3 of 36 (8.3%).
risk of mechanical ventilation, 111.8% higher, RR 2.12, p = 0.42, treatment 4 of 34 (11.8%), control 2 of 36 (5.6%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mahajan et al., 20 Mar 2021, Randomized Controlled Trial, India, peer-reviewed, 3 authors, average treatment delay 6.84 days.
Abstract: Original Article
Clinical outcomes of using remdesivir in patients
with moderate to severe COVID‑19: A prospective
Address for correspondence:
Dr. Lakshmi Mahajan,
Department of Anaesthesia,
SGRD Medical College and
Hospital, 166 e block, Ranjit
Avenue, Amritsar –143 001,
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Lakshmi Mahajan, A P Singh, Gifty
Department of Anaesthesia, Sri Guru Ram Das (SGRD) Medical College and Hospital, Amritsar, Punjab, India
Background and Aims: When the world was frantically searching for a drug effective against the
coronavirus disease (COVID)‑19, remdesivir, a broad‑spectrum anti‑viral medication, became a
part of the COVID treatment. We planned a study to evaluate improvement in clinical outcomes
with remdesivir treatment for five days. Methods: Participants more than 40‑years old and with
moderate to severe COVID‑19 but not on mechanical ventilation were randomly assigned into two
groups‑remdesivir group (34 cases) to receive the study drug intravenous (IV) remdesivir for five
days plus the standard care (SC) and non‑remdesivir group (36 cases) to receive the SC but not
to receive the study drug. Follow‑up was continued for 12 days after the beginning of treatment
or until discharge/death. Patient’s clinical status was assessed by laboratory investigations and
physical examination (from day 1 to day 12 on a 4‑point ordinal scale and from day 12 to 24
on a 6‑point ordinal scale). Oxygen support requirements and adverse events were recorded.
The data were entered and analysed using Statistical Package for the Social Sciences (SPSS)
version 22.0. Results: High‑flow oxygen support and non‑invasive ventilation was required at
baseline by lesser patients in the remdesivir group. In the end, both groups had similar outcomes
after adjustment for baseline clinical status. There was no statistical difference in mortality
between the two groups (p = 0.749). Patients in both groups had an equal time to recovery. There
was no difference in the occurrence of adverse effects of remdesivir between the two groups.
Conclusion: Remdesivir therapy for five days did not produce improvement in clinical outcomes
in moderate to severe COVID‑19 cases.
Key words: COVID‑19, remdesivir, treatment outcome
is less effective
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