144: Clinical Outcomes of Remdesivir in COVID-19: A Systematic Review and Meta-Analysis

INTRODUCTION: In the current COVID-19 pandemic, as no proven effective treatment is available, the most efficient strategy is to re-purpose existing antiviral drugs Remdesivir has demonstrated broad spectrum antiviral activity against an array of RNA virus families Our systematic review and metaanalysis provides a detailed overview of existing literature on remdesivir in COVID-19 to evaluate the benefits and adverse events of this potential drug METHODS: A systematic search was conducted for articles published between inception and July 31, 2020 focusing on the use of remdesivir in COVID-19 The primary outcomes were defined as mortality rate and median days to recovery and the secondary outcome was pooled adverse events rate and pooled drug discontinuation rate Statistical analysis was performed using the Comprehensive Meta-Analysis software package (Bio stat, Englewood, NJ, USA) RESULTS: Six studies were included in our meta-analysis A total of 1858 patients were included In patients treated with remdesivir, the median recovery time was 15 84 days (95% CI 11 68-20 00, p<0 0001) and the pooled mortality rate was 9 9% (95% CI 7 0%- 13 8%, p <0 0001) The results of three clinical trials indicated that administration of remdesivir significantly reduces the mortality compared to the placebo (OR 0 70, 95% CI 0 58-0 84, p-value 0 000) as well as shortens the recovery time (OR 1 32;95% CI 1 12 to 1 55, p < 001) However, treatment with remdesivir was associated with adverse effects (62 5%, 95% CI 35 9%- 83 3%, p=0 36) eventually warranting the discontinuation of the drug (16 7%, 95% CI 7 2%- 34 3%, p<0 001) CONCLUSIONS: The results of our meta-analysis suggests that pooled mortality rate of patients of COVID-19 with remdesivir is low The median recovery time was found to be over two weeks Our meta-analysis suggests that there may be a favorable risk-benefit profile for remdesivir compared with placebo in severe COVID-19 infection