Real-world effectiveness of remdesivir in patients with coronavirus disease 2019 (COVID-19): A systematic review

COVID-19, caused by the SARS-CoV-2 virus, has been a global health crisis, affecting individuals of all ages and leading to complications like ARDS, sepsis, and multi-organ failure. The pandemic has notably impacted healthcare systems in countries like India and Indonesia. Remdesivir has emerged as a popular treatment option, but its real-world effectiveness remains a subject of debate due to varying patient demographics, disease severities, and healthcare settings. This review aims to systematically analyse observational study data to evaluate the real-world efficacy of Remdesivir in treating COVID-19 patients across various global healthcare settings. It focuses on patients with moderate to severe COVID-19, synthesizing data to understand the role and benefits as well as potential limitations of Remdesivir in clinical practice. The review protocol was registered with PROSPERO and involved comprehensive literature searches in databases like PubMed, the Cochrane Library, and Google Scholar. The search, spanning from the beginning of the pandemic until April 2022, focused on studies involving adult patients with severe or serious COVID-19 treated with Remdesivir. Data extraction followed a standardized form, and the quality of non-randomized studies was assessed using the ROBINS-I method. The review included a narrative synthesis due to the heterogeneity of the studies. The review analysed data from nine studies, revealing varied outcomes in terms of The World Health Organization (WHO) ordinal scale clinical improvement, mortality rates, need for oxygen support and hospital stay length. The results indicated that Remdesivir, particularly in combination with other treatments like corticosteroids, could have a positive impact on reducing symptom severity, mortality rates, and hospitalization duration in COVID-19 patients. Remdesivir, as part of COVID-19 treatment Regimens, shows promise in real-world clinical settings, particularly in reducing the severity and mortality of the disease. However, Remdesivir effectiveness varies based on patient demographics, disease severity, and the healthcare environment. Future research should focus on long-term outcomes and the identification of patient subgroups that could benefit the most from Remdesivir.