| Outcome |
Relative effect
(95% CI) |
Absolute effect
(95% CI)1 |
Certainty of the Evidence
(GRADE) |
Clinical improvement
D28 |
RR: 1.06
(0.87 - 1.30) |
42 more per 1000
(from 92 fewer to 212 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: Very serious
due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
|
| 2 trials
Spinner CD, 2020; Goldman JD, 2020
798 participants
|
|
Remdesivir 5 days
750 per 1,000
(616 - 920) |
Remdesivir 10 days
708
per 1,000 |
|
Clinical improvement
D60 |
Outcome not yet measured or reported
|
|
WHO progression score (level 7 or above)
D28 |
RR: 0.49
(0.09 - 2.67) |
10 fewer per 1000
(from 18 fewer to 34 more)
|
Low certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Not serious
Multicentre study conducted across several countries, therefore not downgraded for indirectness Imprecision: Very serious
due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
|
| 1 trials
Spinner CD, 2020
396 participants
|
|
Remdesivir 5 days
10 per 1,000
(2 - 54) |
Remdesivir 10 days
20
per 1,000 |
|
WHO progression score (level 7 or above)
D60 |
Outcome not yet measured or reported
|
|
All-cause mortality
D28 |
RR: 0.87
(0.53 - 1.40) |
10 fewer per 1000
(from 37 fewer to 31 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
due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
|
| 2 trials
Spinner CD, 2020; Goldman JD, 2020
798 participants
|
|
Remdesivir 5 days
68 per 1,000
(41 - 109) |
Remdesivir 10 days
78
per 1,000 |
|
All-cause mortality
D60 |
Outcome not yet measured or reported
|
|
Viral negative conversion
D7 |
Outcome not yet measured or reported
|
|
Adverse events
|
RR: 0.79
(0.69 - 0.90) |
144 fewer per 1000
(from 213 fewer to 69 fewer)
|
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
due to low number of participants/events
|
| 2 trials
Spinner CD, 2020; Goldman JD, 2020
798 participants
|
|
Remdesivir 5 days
543 per 1,000
(474 - 619) |
Remdesivir 10 days
688
per 1,000 |
|
Serious adverse events
|
RR: 0.65
(0.48 - 0.89) |
69 fewer per 1000
(from 102 fewer to 22 fewer)
|
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
due to low number of participants/events
|
| 2 trials
Spinner CD, 2020; Goldman JD, 2020
798 participants
|
|
Remdesivir 5 days
128 per 1,000
(94 - 175) |
Remdesivir 10 days
196
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
