Supplementary Data — Remdesivir for COVID-19: real-time meta-analysis of 81 studies

October 2026

Remdesivir COVID-19 outcomes

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk
Gottlieb (DB RCT)87%0.13 · 0.03–0.59death/hosp.2/27915/283PINETREE Gottlieb (DB RCT)72%0.28 · 0.11–0.75hosp.5/27918/283PINETREE Gottlieb (DB RCT)29%0.71 · 0.37–1.37no recov.43/6645/60PINETREE Gottlieb (DB RCT)48%0.52 · 0.34–0.79no recov.108/169132/165PINETREE Killingley−60%1.60 · 0.51–5.03progression6 (n)12 (n) Piccicacco66%0.34 · 0.01–8.32death0/821/90 Piccicacco30%0.70 · 0.28–1.72hosp.7/8211/90 Piccicacco52%0.48 · 0.21–0.96hosp./ER9/8221/90 Piccicacco78%0.22 · 0.05–0.97progression2/8210/90 Kneidinger20%0.80 · 0.35–1.82severe case6/4628/172 Ong−75%1.75 · 0.23–13.03recov. time4 (n)14 (n) Ong−56%1.56 · 0.67–3.60hosp. time4 (n)14 (n) Ong−61%1.61 · 0.86–3.00viral time4 (n)14 (n) Chew−68%1.68 · 0.51–5.58progression12 (n)151 (n) Jittamala (RCT)66%0.34 · 0.01–8.12hosp.0/671/69PLATCOV Jittamala (RCT)29%0.71 · 0.61–0.83viral rate67 (n)69 (n)PLATCOV Seah−129%2.29 · 0.26–20.13no recov.2/71/8 Choi−267%3.67 · 0.20–3.27death308 (n)13,656 (n) Choi−600%7.00 · 4.00–11.50ICU308 (n)13,656 (n) Choi−686%7.86 · 6.40–9.40oxygen308 (n)13,656 (n) Choi−182%2.82 · 2.35–3.33misc.308 (n)13,656 (n) Siami−70%1.70 · 0.76–3.82hosp.341 (n)148 (n) Wang (RCT)−9%1.09 · 0.54–2.18death22/15810/78 Wang (RCT)24%0.76 · 0.29–1.95death8/717/47 Wang (RCT)−48%1.48 · 0.45–4.88death12/843/31 Olender59%0.41 · 0.24–0.71death24/312102/818 Spinner (RCT)35%0.65 · 0.18–2.40death5/3844/200 Pasquini (ICU)16%0.84 · 0.69–0.94death14/2524/26ICU patients Fried61%0.39 · 0.15–0.99death4/482,510/11,673 Fried−37%1.37 · 0.81–2.30ventilation11/481,956/11,673 Beigel (RCT)27%0.73 · 0.52–1.03death541 (n)521 (n)ACTT-1 Beigel (RCT)45%0.55 · 0.36–0.83death541 (n)521 (n)ACTT-1 Beigel (RCT)22%0.78 · 0.67–0.89no recov.541 (n)521 (n)ACTT-1 SOLIDARITY .. (RCT)5%0.95 · 0.81–1.11death301/2,743303/2,708SOLIDARITY El-Solh29%0.71 · 0.52–0.97death63/219202/424 Flisiak49%0.51 · 0.19–1.30death5/12217/211SARSTer Flisiak58%0.42 · 0.13–1.18death4/8214/119SARSTer Flisiak56%0.44 · 0.21–0.86no improv.9/12236/211SARSTer Garibaldi20%0.80 · 0.46–1.41death23/30345/303 Garibaldi35%0.65 · 0.53–0.78no improv.52/30380/303 Ullah−100%2.00 · 0.67–5.94death8/304/30 Ullah−250%3.50 · 0.79–15.50ventilation7/302/30 Yeramaneni−24%1.24 · 0.11–14.19death32 (n)7,126 (n) Goldberg9%0.91 · 0.50–1.67hosp. time29 (n)113 (n) Goldberg0%1.00 · 0.92–1.09viral+29 (n)113 (n) Tsuzuki−4%1.04 · 0.98–1.09death69/824285/11,663 Tsuzuki2%0.98 · 0.91–1.07ventilation48/82498/11,663 Tsuzuki15%0.85 · 0.41–1.77progression559/8241,784/11,663 Mahajan (RCT)−76%1.76 · 0.46–6.82death5/343/36 Mahajan (RCT)−112%2.12 · 0.41–10.82ventilation4/342/36 Mulhem−86%1.86 · 0.21–5.24death1/8515/3,211 Haji Aghajani19%0.81 · 0.46–1.46death46 (n)945 (n) Elhadi (ICU)−11%1.11 · 0.81–1.51death14/21267/444ICU patients Pourhoseingholi−2%1.02 · 0.72–1.44death42/123297/2,345 Arch (PSM)20%0.80 · 0.64–0.98death203/1,491777/4,676 Arch (PSM)18%0.82 · 0.63–1.06death140/1,502565/4,728 Arch (PSM)−68%1.68 · 1.19–2.34ventilation106/1,498153/4,602 Arch (PSM)−47%1.47 · 1.18–1.83misc.124/1,443241/4,483 Barrat-Due (DB RCT)0%1.00 · 0.20–4.60death3/424/57NOR-Solidarity Barrat-Due (DB RCT)−36%1.36 · 0.29–6.39death3/423/57NOR-Solidarity Barrat-Due (DB RCT)55%0.45 · 0.05–4.20death1/423/57NOR-Solidarity Barrat-Due (DB RCT)−47%1.47 · 1.10–1.98no recov.42 (n)76 (n)NOR-Solidarity Barrat-Due (DB RCT)−43%1.43 · 1.09–1.87no recov.42 (n)76 (n)NOR-Solidarity Barrat-Due (DB RCT)−24%1.24 · 0.96–1.60no recov.42 (n)76 (n)NOR-Solidarity Barrat-Due (DB RCT)−50%1.50 · 1.01–2.23no recov.42 (n)76 (n)NOR-Solidarity Ohl (PSM)−6%1.06 · 0.83–1.36death143/1,172124/1,172 Ohl (PSM)−100%2.00 · 1.33–3.02hosp. time1,172 (n)1,172 (n) Kuno (PSM)1%0.99 · 0.84–1.17death214/999216/999 Kuno (PSM)0%1.00 · 0.80–1.24ventilation140/999140/999 Kuno (PSM)−17%1.17 · 1.00–1.37ICU260/999222/999 Elavarasi−137%2.37 · 1.98–2.83death146/403207/1,352 Diaz35%0.65 · 0.46–0.92death33/286173/852 Diaz44%0.56 · 0.32–0.97death286 (n)852 (n) Ader (RCT)6%0.94 · 0.59–1.45death34/41437/418DISCOVERY Ader (RCT)12%0.88 · 0.50–1.56death21/41424/418DISCOVERY Ader (RCT)10%0.90 · 0.70–1.157-point status414 (n)418 (n)DISCOVERY Ader (RCT)−2%1.02 · 0.80–1.307-point status414 (n)418 (n)DISCOVERY Mozaffari12%0.88 · 0.81–0.96death4,441/28,8555,499/28,855 Mozaffari24%0.76 · 0.69–0.83death3,057/28,8554,437/28,855 Sarhan (RCT)−35%1.35 · 0.70–2.60death15/5212/56OT1 Sarhan (RCT)−35%1.35 · 0.70–2.60no disch.15/5212/56OT1 Schmidt (PSM)−509%6.09 · 2.71–13.68severe case43 (n)434 (n) Mustafa33%0.67 · 0.38–1.20death16/20029/244 Ali (RCT)12%0.88 · 0.72–1.07death127/634152/647CATCO Ali (RCT)17%0.83 · 0.67–1.03death117/634145/647CATCO Ali (RCT)21%0.79 · 0.40–1.58death14/63418/647CATCO Ali (RCT)47%0.53 · 0.38–0.75ventilation46/63489/647CATCO Ali (RCT)9%0.91 · 0.73–1.14no recov.634 (n)647 (n)CATCO Ali (RCT)−11%1.11 · 1.01–1.23hosp. time634 (n)647 (n)CATCO Kurniyanto−460%5.60 · 2.32–13.50death7/4512/432 Siraj53%0.47 · 0.35–0.62death108/413197/587 Salehi (ICU)37%0.63 · 0.43–0.94death17/4057/85ICU patients Elec19%0.81 · 0.38–1.69death7/3829/127 Elec11%0.89 · 0.45–1.78ventilation8/3830/127 Elec−72%1.72 · 1.11–2.66ICU18/3835/127 Malundo−17%1.17 · 0.80–1.70death24/115197/1,100 Bowen−57%1.57 · 1.25–1.97death817 (n)3,814 (n) Raad42%0.58 · 0.39–0.88deathn/an/a Oku−40%1.40 · 0.41–4.36death3/468/172 Behboodikhah38%0.62 · 0.30–1.30death1,214 (n)960 (n) Cacho−80%1.80 · 0.37–8.82death5/572/41 Cacho−44%1.44 · 0.53–3.89severe case10/575/41 Cacho−73%1.73 · 0.93–3.21m/s case24/5710/41 Cacho−92%1.92 · 0.54–6.79no disch.8/573/41 Hartantri11%0.89 · 0.31–2.53deathn/an/a Hartantri24%0.76 · 0.33–1.77deathn/an/a Alshamrani (PSM)17%0.83 · 0.72–0.93death137/246725/1,078 Alshamrani (PSM)4%0.96 · 0.90–1.00progression215/246984/1,078 Alshamrani (PSM)−43%1.43 · 1.13–1.80ICU245 (n)995 (n) Alshamrani (PSM)7%0.93 · 0.81–1.05hosp. time246 (n)1,078 (n) Mitsushima−44%1.44 · 1.09–1.90deathn/an/a Punzalan−42%1.42 · 0.92–2.20death47/22426/176 Punzalan−59%1.59 · 1.19–2.13progression93/22446/176 Kim−1612%17.12 · 1.06–277death14/1450/22 Aweimer−13%1.13 · 0.93–1.37death40/5168/98Intubated patients Arfijanto1%0.99 · 0.64–1.53viral+17/4446/118 Bavaro (PSW)7%0.93 · 0.89–0.97severe case120 (n)211 (n) Shamsi−23%1.23 · 0.56–2.69death8/5316/130 Mozaffari (PSM)25%0.75 · 0.68–0.83death14,169 (n)5,341 (n) Mozaffari (PSM)30%0.70 · 0.62–0.78death14,169 (n)5,341 (n) Nadeem−12%1.12 · 0.39–3.26death12/964/36 Burhan (ICU)−15%1.15 · 0.96–1.37death33/43345/516ICU patients Hagman0%1.00 · 0.60–1.80death105 (n)213 (n) Hagman0%1.00 · 0.50–1.90death105 (n)213 (n) Hagman20%0.80 · 0.30–2.40death105 (n)213 (n) Hagman−40%1.40 · 0.80–2.40progression105 (n)213 (n) Hagman29%0.71 · 0.50–1.11viral+105 (n)213 (n) Ho−62%1.62 · 1.35–1.95death5,294 (n)21,151 (n) Amirizadeh (ICU)−3%1.03 · 0.86–1.24death31/3530/35ICU patients Amirizadeh (ICU)−52%1.52 · 0.83–2.78ventilation time35 (n)35 (n)ICU patients Amirizadeh (ICU)−27%1.27 · 0.86–1.88ICU35 (n)35 (n)ICU patients Amirizadeh (ICU)−24%1.24 · 0.88–1.75hosp. time35 (n)35 (n)ICU patients Muntean−45%1.45 · 1.04–2.03death71/28745/264 Chang−185%2.85 · 1.03–7.85death81 (n)81 (n) Alsaraj (RCT)−83%1.83 · 0.66–5.11death9/525/53 Liao−25%1.25 · 0.55–2.86death37/593/6 Sokolski0%1.00 · 0.67–1.47death88 (n)460 (n) Lewandowski−21%1.21 · 0.66–2.22death430 (all patients) Drouin−46%1.46 · 1.15–1.54severe case52/102135/354 Milan−34%1.34 · 0.20–8.91death1/816/172 Milan−122%2.22 · 0.86–5.78ventilation3/829/172 Milan−419%5.19 · 3.40–7.92ICU7/829/172 Sise (DB RCT)−6%1.06 · 0.72–1.55death55/16626/83REDPINE Sise (DB RCT)0%1.00 · 0.67–1.49death51/16325/80REDPINE Sise (DB RCT)17%0.83 · 0.50–1.39death41/16323/80REDPINE Sise (DB RCT)18%0.82 · 0.50–1.32death/int.48/16326/80REDPINE Sise (DB RCT)16%0.84 · 0.52–1.38misc.163 (n)80 (n)REDPINE Sise (DB RCT)−5%1.05 · 0.64–1.72misc.163 (n)80 (n)REDPINE Anzalone (PSM)−33%1.33 · 1.29–1.37deathn/an/a Anzalone (PSM)8%0.92 · 0.89–0.96ventilationn/an/a Kawther−9%1.09 · 0.46–2.57death111 (n)340 (n) Angleitner−223%3.23 · 1.46–7.17viral time8 (n)55 (n) Mohammed (PSM)67%0.33 · 0.04–3.15death1/1013/101 Mohammed (PSM)−117%2.17 · 1.63–2.91hosp. time101 (n)101 (n) Mohammed (PSM)−58%1.58 · 1.11–2.26misc.49/10131/101 Floridia−23%1.23 · 0.78–1.95PASC318 (n)1,216 (n) Heiran−22%1.22 · 0.89–1.66deathn/an/a
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1 OT: comparison with other treatment
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← Remdesivir
reduces risk
Remdesivir
increases risk →
Fig. S1. All outcomes.
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Fig. S2. Comparison of results for RCTs versus observational studies. For COVID-19 treatments, there is no significant difference between the results of RCTs and observational studies. Observational studies do not systematically over or underestimate efficacy. For high-cost treatments, there is a non-significant trend towards RCTs showing greater efficacy.