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