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0 0.5 1 1.5 2+ Deescalation -129% Improvement Relative Risk Remdesivir for COVID-19  Seah et al.  EARLY TREATMENT Is early treatment with remdesivir beneficial for COVID-19? Retrospective 15 patients in Singapore (January 2020 - March 2022) Worse recovery with remdesivir (not stat. sig., p=0.57) Seah et al., Health Science Reports, Dec 2023 Favors remdesivir Favors control

Remdesivir therapy for severe pediatric COVID‐19 in Singapore: A single‐center retrospective observational cohort study

Seah et al., Health Science Reports, doi:10.1002/hsr2.1698
Dec 2023  
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Retrospective 15 pediatric patients hospitalized for severe COVID-19 requiring oxygen and high dependency/intensive care unit (HD/ICU) admission in Singapore, showing no improvement in deescalation from HD/ICU care with remdesivir, however the remdesivir group had higher disease severity.
Gérard, Wu, Zhou show significantly increased risk of acute kidney injury with remdesivir.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with significant baseline differences.
no deescalation, 128.6% higher, RR 2.29, p = 0.57, treatment 2 of 7 (28.6%), control 1 of 8 (12.5%), day 5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Seah et al., 14 Dec 2023, retrospective, Singapore, peer-reviewed, median age 2.5, 9 authors, study period 1 January, 2020 - 18 March, 2022. Contact:,,
This PaperRemdesivirAll
Remdesivir therapy for severe pediatric COVID‐19 in Singapore: A single‐center retrospective observational cohort study
Valerie Xue Fen Seah, Rina Yue Ling Ong, Kai Qian Kam, Koh Cheng Thoon, Natalie Woon Hui Tan, Jiahui Li, Karen Donceras Nadua, Chia Yin Chong, Chee Fu Yung
Health Science Reports, doi:10.1002/hsr2.1698
Background and Aims: There is a paucity of information on remdesivir (RDV) use in severe pediatric coronavirus disease 2019 (COVID-19). We aimed to explore the effectiveness of RDV as the cumulative proportion of pediatric COVID-19 patients deescalated from Day 5 of high dependency or intensive care unit (HD/ICU). Methods: All children ≤18 years admitted to Singapore's largest pediatric hospital from January 1, 2020 to March 18, 2022 were reviewed retrospectively. Patients were included if they were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on reverse transcriptase polymerase chain reaction, required oxygen, and HD/ICU care. The characteristics and outcomes of those who received RDV or not (no-RDV) were compared. Results: We reviewed 15 children with a median age of 2.5 years (interquartile range [IQR]: 0.8-11.0), of which 7 (46.7%) received RDV. There was no difference in cumulative proportion of children deescalated from Day 5 of HD/ICU care in the RDV versus the no-RDV group (5/7, 70% vs. 7/8, 87.5%, p = 0.57). The RDV versus no-RDV group had higher disease severity, that is, WHO Ordinal Scale scores (median 6, IQR: 5-7 vs. 5, IQR: 4-5, p = 0.03), higher procalcitonin levels (ug/L) (median 4.31, IQR: 0.8-24.2 vs. 0.12, IQR: 0.09-0.26, p = 0.02), and longer HD/ ICU care days (median 5, IQR: 4-9, vs. 1, IQR: 1-4, p = 0.01). There was no significant difference in hospitalization days. There were no adverse events directly attributable to RDV. None died from COVID-19 infection. Conclusion: Our observational analysis was unable to detect any clear benefit of RDV in terms of reducing duration in HD/ICU. RDV was well-tolerated in children with severe COVID-19.
AUTHOR CONTRIBUTIONS Valerie Xue Fen Seah: Formal analysis; methodology; supervision; writing-original draft; writing-review and editing. Rina Yue Ling Ong: Formal analysis; writing-review and editing. Kai Qian Kam: Conceptualization; methodology; supervision; writing-review and editing. Koh Cheng Thoon: Writing-review and editing. Natalie Woon Hui Tan: Writing-review and editing. Jiahui Li: Writingreview and editing. Karen Donceras Nadua: Writing-review and editing. Chia Yin Chong: Conceptualization; methodology; writingreview and editing. Chee Fu Yung: Conceptualization; formal analysis; methodology; writing-review and editing. CONFLICT OF INTEREST STATEMENT The authors declare no conflict of interest.
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