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Remdesivir for COVID-19: real-time meta analysis of 79 studies

https://c19early.org/smeta.html

Updated January 2025
c19early.org

Version 98

"Introduction

Analysis: We analyze all significant controlled studies of remdesivir for COVID-19... We present random effects meta-analysis results for all studies, studies within each treatment stage, individual outcomes, peer-reviewed studies, Randomized Controlled Trials (RCTs), and higher quality studies.

Conclusion

Meta analysis [of 79 studies] using the most serious outcome reported shows 2% [-6-1 1%] higher risk without reaching statistical significance. Meta regression with followup duration shows that mortality results are worse with longer followup. This may reflect antiviral efficacy being offset by side effects of treatment.
 
Studies show significantly increased risk of acute kidney injury. Variants may be less susceptible to remdesivir.
 
Prescription treatments have been preferentially used by patients at lower risk. Retrospective studies may overestimate efficacy, for example patients with greater knowledge of effective treatments may be more likely to access prescription treatments but result in confounding because they are also more likely to use known beneficial non-prescription treatments."

"We aim to cover the most promising early treatments for COVID-19. We use pre-specified effect extraction criteria that prioritizes more serious outcomes, for details see methods." (source)

"We perform ongoing searches of PubMed, medRxiv, Europe PMC, ClinicalTrials.gov, The Cochrane Library, Google Scholar, Research Square, ScienceDirect, Oxford University Press, the reference lists of other studies and meta-analyses, and submissions to the site c19ivm.org, which regularly receives submissions of studies upon publication... Automated searches are performed twice daily, with all matches reviewed for inclusion... Sensitivity analysis is performed, excluding studies with major issues, epidemiological studies, and studies with minimal available information. This is a living analysis and is updated regularly." (source)

@CovidAnalysis

Public domain CC0 1.0

document
adverse events,all cause mortality,clinical trials,COVID-19,health statistics,medical treatment protocols,medical treatments,remdesivir