Remdesivir for severe Covid-19: a clinical practice guideline

An international guideline panel makes a weak recommendation for the use of remdesivir in severe covid-19 while recommending continuation of active enrolment of patients into ongoing randomised controlled trials examining remdesivir.

SPS commentary:

This BMJ Rapid Recommendation represents the first in a series of recommendations for the management of covid-19. A linked living systematic review identified two randomised trials of remdesivir which show it may decrease mortality in patients with severe covid-19 (absolute effect estimate 8.5% reduction [95% CI 16.5% reduction to 3.0% increase], but this is based on low certainty evidence with very serious imprecision. It may also reduce time to clinical improvement (mean difference 3.04 days fewer (0.89 to 5.19 days fewer), but this also has low certainty due to imprecision and indirectness.

The panel suggests remdesivir rather than no remdesivir for the treatment of adult patients with severe covid-19 infection (weak recommendation) and they call for RCTs examining remdesivir in patients with covid-19 to continue.

British Medical Journal

Resource links:

Systematic review