Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.06.22.20136531; this version posted June 29, 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 The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Efficacy and Safety of Remdesivir for COVID-19 Treatment: An Analysis of Randomized, Double-Blind, Placebo-Controlled Trials Yun Zhu1, M.D., Zhaowei Teng1,2,3, Ph.D., Lirong Yang3, Ph.D., Shuanglan Xu3, M.D., Jie Liu3, M.D., Yirong Teng1, M.D., Qinggang Hao2, M.D., Dake Zhao2, Ph.D., Xiaolan Li4, M.D., Sheng Lu2, M.D., Yong Zeng1, M.D. 1 The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China 2 The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China 3 Graduate School of Kunming Medical University, Kunming, China 4 The Second Affiliated Hospital of Kunming Medical University, Kunming, China All authors contributed equally to this paper. Correspondence to: Yun Zhu The Sixth Affiliated Hospital of Kunming Medical University 21 Nieer Road, Yuxi 653100, Yunnan, China Tel.: (86) 13887731212 e-mail: zhuyun8377@163.com NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. 1 medRxiv preprint doi: https://doi.org/10.1101/2020.06.22.20136531; this version posted June 29, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Abstract BACKGROUND Remdesivir, an inhibitor of viral RNA-dependent RNA polymerases, has been identified as a candidate for COVID-19 treatment. However, the therapeutic effect of remdesivir is controversial. METHODS We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials, from inception to June 11, 2020 for randomized controlled trials on the clinical efficacy of remdesivir. The main outcomes were discharge rate, mortality, and adverse events. This study is registered at INPLASY (INPLASY202060046). RESULTS Data of 1075 subjects showed that remdesivir significantly increased the discharge rate of patients with COVID-19 compared with the placebo (50.4% vs. 45.29%; relative risk [RR] 1.19 [95% confidence interval [CI], 1.05–1.34], I2 = 0.0%, P = 0.754). It also significantly decreased mortality (8.18% vs. 12.70%; RR 0.64 [95% CI, 0.44–0.92], I2 = 45.7%, P = 0.175) compared to the placebo. Data of 1296 subjects showed that remdesivir significantly decreased the occurrence of serious adverse events (RR 0.77 [95% CI, 0.63–0.94], I2 = 0.0%, P = 0.716). CONCLUSION Remdesivir is efficacious and safe for the treatment of COVID-19. TRIAL REGISTRATION NUMBER 2 medRxiv preprint doi: https://doi.org/10.1101/2020.06.22.20136531; this version posted June 29, 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. It is made available under a CC-BY-NC-ND 4.0 International license . This study is registered at the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY202060046). 3 medRxiv preprint doi: https://doi.org/10.1101/2020.06.22.20136531; this version posted June 29, 2020...