The Safety and Efficacy of Remdesivir-dexamethasone Combination Therapy Versus Dexamethasone Monotherapy in COVID-19: A Rapid Review and Meta-analysis

Le résumé fourni par la source

The COVID-19 pandemic has had and is expected to continue having, a profound impact on the physical health of individuals at a global scale. This study aimed to evaluate the efficacy and safety of remdesivir in combination with dexamethasone, compared to dexamethasone alone, in the treatment of COVID-19. To achieve this objective, several global databases, including Google Scholar, PubMed, Scopus, Embase, and ISI, were systematically searched in January 2023. Both MeSH terms and relevant keywords were employed in the search strategy. Statistical analyses were conducted using STATA version 15.0 (StataCorp LLC, College Station, TX, USA). The analysis was conducted using a random-effects model. To assess the degree of heterogeneity among the studies, we utilized the chi-squared test and the I² index. Publication bias was evaluated through Egger’s test and Begg’s funnel plots. Finally, a total of nine studies were included in the analysis. The median length of hospitalization for patients treated with dexamethasone, with or without remdesivir, was 9.89 days (interquartile range: 2.65–21) compared to 11 days (interquartile range: 7–19) (P=0.37), showing no significant difference between the two groups. The mortality rates among patients who received dexamethasone, with or without remdesivir, were 9% (95% CI: 4%, 14%, P=0.00) and 18% (95% CI, 8%, 22%, P=0.00), respectively, irrespective of remdesivir use. Ultimately, the combination of Remdesivir and dexamethasone did not shorten hospital stays. Still, it did result in fewer in-hospital fatalities and a lower fatality rate, which may indicate a decrease in the course of the disease.

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