A NEW systematic review and meta-analysis of over 1.3 million patients has confirmed that remdesivir significantly improves survival rates for hospitalized COVID-19 patients, yet treatment guidelines may not fully reflect this evolving evidence. The study, which analyzed data from both randomized controlled trials (RCTs) and real-world (RW) studies, found that remdesivir reduced overall mortality risk by 31% and significantly lowered rehospitalization rates.
Researchers systematically reviewed 122 studies published between January 2019 and December 2023, screening over 18,000 sources to assess remdesivir’s effectiveness across varying disease severity levels. The findings showed that remdesivir reduced mortality risk across all patient groups, with the strongest effect observed in those on low-flow oxygen (29% reduced risk). Even patients on high-flow oxygen and mechanical ventilation saw survival benefits. Additionally, remdesivir lowered the likelihood of rehospitalization by 28%.
These findings highlight the critical role of remdesivir in COVID-19 treatment, reinforcing its effectiveness beyond initial clinical trials. However, the study authors emphasize that treatment guidelines must evolve alongside the latest evidence to ensure optimal patient care. While current recommendations acknowledge remdesivir, the researchers argue that both RCT and real-world data should guide clinical decisions.
For frontline healthcare professionals, this research underscores the importance of evidence-based treatment decisions in hospitalized patients with COVID-19. As new variants emerge, ensuring treatment guidelines align with the latest clinical data remains essential for improving patient outcomes.
Reference: Bartoletti M et al. A systematic review and meta-analysis of the effectiveness of remdesivir to treat SARS-CoV-2 infection in hospitalized patients: have the guidelines evolved with the evidence? Clin Infect Dis. 2025;ciaf111.
Anaya Malik | AMJ
