Lemdesivir versus standard of care versus standard of care alone for the treatment of patients hospitalized with COVID-19 (DisCoVeRy): a phase 3, randomized, controlled, open-label study

DOI:https://doi.org/10.1016/S1473-3099(21)00485-0

Commentary

This review was designed to evaluate the antiviral efficacy of remdesivir against SARS-CoV-2 compared to standard of care alone in patients hospitalized with COVID-19 and requiring ventilator support.

Between March 22, 2020 and January 21, 2021, 857 participants were enrolled and randomly assigned to receive remdesivir and standard therapy (n = 429) or standard therapy alone (n = 428).

Fifteen participants in the remdesivir group were excluded from the analysis, and 10 participants in the control group were excluded from the analysis.

On day 15, the distribution of the WHO ordinal scale was.

The distribution of the WHO ordinal scale at day 15 was as follows

(1) Not hospitalized, no limitation in activities.

(61 of 414 [15%] in the remdecivir group vs. 73 of 418 [17%] in the control group)

(2) Not hospitalized, limited activity (129 [31%] vs. 132 [32%])

(3) Hospitalized, no need for oxygen supplementation (50 [12%] vs. 29 [7%])

(4) Hospitalized and requiring oxygen supplementation (76 [18%] vs. 67 [16%])

(5) Hospitalized with noninvasive ventilation or high-flow oxygen equipment (15 [4%] vs. 14 [3%])

(6) Hospitalization for invasive ventilation or extracorporeal membrane ventilation (62 [15%] vs 79 [19%])

(7) Death (21 [5%] vs. 24 [6%])

These results showed that the difference between the treatment groups was not significant. (Odds ratio 0.98 [95% CI 0.77-1.25]; p = 0.85) There was also no significant difference in the occurrence of serious adverse events between the treatment groups. (Remdesivir, 406 vs 135 [33%] control, 130 [31%] of 418; p = 0.48)

In this analysis, no clinical benefit was observed with the use of remdecivir for patients hospitalized with COVID-19, symptomatic for more than 7 days, and requiring oxygen support.