| Outcome |
Relative effect
(95% CI) |
Absolute effect
(95% CI)1 |
Certainty of the Evidence
(GRADE) |
Viral negative conversion
D7 |
RR: * |
Zero events in both groups
|
Reasons to downgrade
Risk of bias:
Inconsistency:
Indirectness: Imprecision:
|
| * trials
*
* participants
|
|
Remdesivir 5 days
0 per 1,000
( - ) |
Remdesivir 10 days
0
per 1,000 |
|
Clinical improvement
D28 |
RR: 0.94
(0.77 - 1.15) |
45 fewer per 1000
(from 172 fewer to 112 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention, outcome measurement and selection of reported results Inconsistency: Serious
Inconsistency downgraded by 1 level: I²= 79.3% Indirectness: Not serious Imprecision: Serious
Imprecision downgraded by 1 level: due to low number of events and/or participants
|
| 2 trials
Spinner CD, 2020; Goldman JD, 2020
798 participants
|
|
Remdesivir 5 days
703 per 1,000
(576 - 860) |
Remdesivir 10 days
748
per 1,000 |
|
Clinical improvement
D60 |
RR: * |
Zero events in both groups
|
|
| * trials
*
* participants
|
|
Remdesivir 5 days
0 per 1,000
( - ) |
Remdesivir 10 days
0
per 1,000 |
|
WHO progression score (level 7 or above)
D28 |
RR: 1.72
(1.17 - 2.52) |
61 more per 1000
(from 14 more to 129 more)
|
Low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention and selection of reported results Inconsistency: Not serious Indirectness: Not serious
*
Imprecision: Serious
Imprecision downgraded by 1 level: due to low number of events and/or participants
|
| 2 trials
Spinner CD, 2020; Goldman JD, 2020
798 participants
|
|
Remdesivir 5 days
146 per 1,000
(99 - 214) |
Remdesivir 10 days
85
per 1,000 |
|
WHO progression score (level 7 or above)
D60 |
RR: * |
Zero events in both groups
|
|
| * trials
*
* participants
|
|
Remdesivir 5 days
0 per 1,000
( - ) |
Remdesivir 10 days
0
per 1,000 |
|
All-cause mortality
D28 |
RR: 1.16
(0.71 - 1.87) |
11 more per 1000
(from 20 fewer to 59 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention and selection of reported results Inconsistency: Not serious Indirectness: Not serious Imprecision: Very serious
Imprecision downgraded by 2 levels: due to wide confidence interval consistent with the possibility for benefit and the possibility for harm and very low number of participants
|
| 2 trials
Spinner CD, 2020; Goldman JD, 2020
798 participants
|
|
Remdesivir 5 days
78 per 1,000
(48 - 126) |
Remdesivir 10 days
67
per 1,000 |
|
All-cause mortality
D60 |
RR: * |
Zero events in both groups
|
|
| * trials
*
* participants
|
|
Remdesivir 5 days
0 per 1,000
( - ) |
Remdesivir 10 days
0
per 1,000 |
|
Adverse events
|
RR: 1.27
(1.11 - 1.44) |
147 more per 1000
(from 60 more to 240 more)
|
Low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention, outcome measurement and selection of reported results Inconsistency: Not serious
* Indirectness: Not serious Imprecision: Serious
Imprecision downgraded by 1 level: due to low number of events and/or participants
|
| 2 trials
Spinner CD, 2020; Goldman JD, 2020
798 participants
|
|
Remdesivir 5 days
694 per 1,000
(606 - 786) |
Remdesivir 10 days
546
per 1,000 |
|
Serious adverse events
|
RR: 1.53
(1.13 - 2.08) |
69 more per 1000
(from 17 more to 140 more)
|
Low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention, outcome measurement and selection of reported results Inconsistency: Not serious Indirectness: Not serious
*
Imprecision: Serious
Imprecision downgraded by 1 level: due to low number of events and/or participants
|
| 2 trials
Spinner CD, 2020; Goldman JD, 2020
798 participants
|
|
Remdesivir 5 days
198 per 1,000
(147 - 270) |
Remdesivir 10 days
130
per 1,000 |
|
1The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
CI: Confidence interval; RR: Risk ratio
GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
