Aims COVID-19 outbreak has created a public health catastrophe all over the world. Here, we have aimed to conduct a systematic review and meta-analysis on remdesivir use for COVID-19. Main methods We searched Pubmed, Scopus, Embase, and preprint sites and identified ten studies for qualitative and four studies for quantitative analysis using PRISMA guidelines. The quantitative synthesis was performed using fixed and random effect models in RevMan 5.4. Heterogeneity was assessed using the I-squared (I 2 ) test. Key findings Comparing 10-day remdesivir group with placebo or standard of care (SOC) group, remdesivir reduced 14 days mortality (OR 0.61, CI 0.41–0.91), need for mechanical ventilation (OR 0.73, CI 0.54–0.97), and severe adverse effects (OR 0.69, 95% CI 0.54 to 0.88). Clinical improvement on day 28 (OR 1.59, CI 1.06–2.39), day 14 clinical recovery (OR 1.48, CI 1.19–1.84), and day 14 discharge rate (OR 1.41, CI 1.15–1.73) were better among remdesivir group. Earlier clinical improvement (MD −2.51, CI −4.16 to −0.85); and clinical recovery (MD −4.69, CI −5.11 to −4.28) were seen among the remdesivir group. Longer course (10 days) of remdesivir showed a higher discharge rate at day 14 (OR 2.11, CI 1.50–2.97), but there were significantly higher rates of serious adverse effects, and drug discontinuation than the 5-day course. Significance Remdesivir showed a better 14 days mortality profile, clinical recovery, and discharge rate. Overall clinical improvement and clinical recovery were earlier among the remdesivir group. 10-day remdesivir showed more adverse outcome than 5-day course with no significant benefits.

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Due to a lack of definitive treatment, many drugs were repurposed for Coronavirus disease (COVID-19) treatment; among them, corticosteroid is one. However, its benefit or harm while treating COVID-19 is not fully studied. Thus, we conducted this meta-analysis to assess the rationality on the use of corticosteroids in COVID-19. Pubmed, Medline, Clinicaltrials.gov, Cochrane library, and Preprint publisher were searched. In the qualitative syntheses, 41, and quantitative studies, 40, were included using PRISMA guidelines. Assessment of heterogeneity was done using the I-squared (I 2) test and random/fixed effect analysis was done to determine the odds/risk ratio. We found severely ill COVID-19 patients almost 5 (OR 4.78, 2.76-8.26) times higher odds of getting corticosteroids during their treatment. Similarly, the odds for corticosteroids in addition to standard of care (SOC) were approximately 4 (OR 4.09, 1. 89-8.84) times higher among intensive care unit (ICU) patients than non-ICU ones. A higher mortality risk with the corticosteroidreceiving group compared with the SOC alone (RR 2.01, 1.12-3.63) was observed. Neither increased discharge rate (RR 0.79, 0.63-0. 99) nor recovery/improvement rate was shown among the corticosteroid-receiving group (OR 0.24, 0.13-0.43). Approximately, the overall 4-day longer hospital stay was found among the treatment groups (MD 4.19, 2.57-5.81). For the negative conversion of reverse transcription-polymerase chain reaction (RT-PCR), approximately a 3-day (MD 2.42, 1.31-3.53) delay was observed with corticosteroid treatment cases. Our study concludes that more severe and critically ill patients tend to get corticosteroids, and the mortality risk increases with the use of corticosteroids. With the use of corticosteroids, delayed recovery and a longer hospital stay were observed.

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Background Due to a lack of definitive treatment, many drugs were repurposed for COVID-19 treatment, among them corticosteroid is one. However, its benefit or harm while treating COVID-19 is not fully studied. Thus, we conducted this meta-analysis to assess the rationality on the use of corticosteroids in COVID-19. Methods Pubmed, Medline, Clinicaltrials.gov, Cochrane library, and Preprint publisher were searched. In the qualitative synthesis, 41 and quantitative 40 studies were included using PRISMA guidelines. Assessment of heterogeneity was done using the I-squared (I 2 ) test and random/fixed-effect analysis was done to determine the odds/risk ratio. Results We found severely ill COVID-19 patients almost 5 (OR 4.78, 2.76-8.26) times higher odds of getting corticosteroids during their treatment. Similarly, the odds for corticosteroids in addition to standard of care (SOC) were approximately 4 (OR 4.09, 1.89-8.84) times higher among intensive care unit (ICU) patients than non-ICU ones. A higher mortality risk with corticosteroids receiving group compared with the SOC alone (RR 2.01, 1.12-3.63) was observed. Niether increased discharge rate (RR 0.79, 0.63-0.99) nor recovery/ improvement rate was shown among corticosteroids group (OR 0.24, 0.13-0.43). Approximately, the overall 4 days longer hospital stay was found among the treatment groups (MD 4.19, 2.57-5.81). For the negative conversion of reverse transcription- polymerase chain reaction (RT-PCR), approximately 3 days (MD 2.42, 1.31-3.53) delay was observed with corticosteroids treatment cases. Conclusion Our study concludes that more severe and critically ill patients tend to get corticosteroids and the mortality risk increases with the use of corticosteroids. With the use of corticosteroids, delayed recovery and a longer hospital stay were observed.