COVID-19: Remdesivir for Hospitalized Adults - A Living Rapid Review

Prepared by: Evidence Synthesis Program (ESP) Center Minneapolis VA Health Care System Minneapolis, MN Timothy J. Wilt, MD, MPH, Director Recommended citation: Wilt TJ, Kaka AS, MacDonald R, et al. COVID-19: Remdesivir for Adults – A Living Review. Updated May 2021. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs. VA ESP Project #09-009; 2021.

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Rationale and Background

Individuals hospitalized with COVID-19 infection are at substantial risk of prolonged hospitalization, experiencing hypoxic respiratory failure, needing advanced airway support, developing end-organ damage, and dying. Remdesivir is a nucleotide analogue prodrug that inhibits viral RNA polymerases and is administered intravenously. While originally developed as a potential treatment for other viral infections including Ebola, it has shown in vitro activity against SARS-CoV-2. Numerous randomized controlled trials of remdesivir have been completed. On October 22nd, 2020 the FDA approved remdesivir for the treatment of patients over age 12 and weighing more than 40 kg hospitalized with COVID-19. As part of our living review and rapid response we provide our first update with additional information on the clinical effectiveness and harms of remdesivir in hospitalized adults with COVID-19.

Questions

What are the effectiveness and harms of remdesivir for hospitalized patients with COVID-19?

Do effectiveness and harms vary by symptom duration, disease severity, and treatment duration?

See also

Kaka A, Macdonald R, Greer N, et al. Major Update: Remdesivir for Adults with COVID-19 - A Living Systematic Review and Meta-analysis for the American College of Physicians Practice Points. Annals of Internal Medicine. Published online February 9, 2021. DOI: https//doi.org/10.7326/M20-8148.

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