Summary of evidence and outcomes reported by guidelines discussing remdesivir

GuidelinesRCTsOutcomes considered
ACTT-1 (NCT04280705) [5]SIMPLE Severe (NCT04292899) [44]SIMPLE Moderate (NCT04292730) [58]WHO Solidarity (NCT04315948/ ISRCTN83971151) [42]Wang 2020 (NCT04257656) [43]Mahajan 2021 (NCT NR) [45]CostMortalityClinical recoveryDischargeSafetyTime to ICU admissionProgression to IMVOther
Guidelines recommending for the use of remdesivir in at least one population described
COVID-19 Advisory Ontarioa
Government of Mexico
Guidelines recommending against the use of remdesivir in any population described#
MoH Brazilf

“✓”: guideline explicitly mentions evidence or outcome. Empty cell: guideline does not explicitly mention evidence or outcome. #: includes guidelines which only provided recommendations against remdesivir or recommended against remdesivir for at least one disease severity category and reported insufficient evidence for any other categories. Organisations: AWMF: Association of the Scientific Medical Societies in Germany; CIDS: Clinical Infectious Disease Society; ERS: European Respiratory Society; IDSA: Infectious Disease Society of America; J-SSCG: Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock; MoH: Ministry of Health; NICE: National Institute for Health and Care Excellence; NIH: National Institutes of Health; SIP: Italian Society of Pulmonology; SITA: Italian Society of Anti-Infective Therapy; SSC: Surviving Sepsis Campaign; WHO: World Health Organization. Abbreviations: ICU: intensive care unit; IMV: invasive mechanical ventilation; NCT: National Clinical Trial; NR: not reported; RCT: randomised controlled trial. Other outcomes considered: a: ICU length of stay was considered; however, published data precluded the pooling of trials for ICU length. Need for oxygen support was considered. Clinical improvement outcomes were considered. b: septic shock within 28 or 30 days; acute respiratory failure or acute respiratory distress syndrome (ARDS) within 28 and 30 days. c: clinical improvement at Day 15, clinical status distribution on Day 11+Day 14. d: additional end-points which were searched for by the guideline development committee but were either not studied or data were not found in an extractable format were: deterioration in those not requiring ventilation at start of treatment; requirement for oxygen; hospital admission; ICU length of stay; need for noninvasive ventilation; hospital length of stay; severity of symptoms; improvement in oxygen saturations or arterial blood gases; relapse and duration of fever. e: viral clearance (7 days); acute kidney injury; delirium; time to clinical improvement; duration of ventilation. f: lack of benefit in patients using IMV. g: clinical worsening: new need for noninvasive mechanical ventilation or high-flow oxygen at day 28; clinical worsening: new need for oxygen by mask or nasal prongs at day 28; quality of life. h: progression to oxygen therapy; progression to noninvasive ventilation or high-flow oxygen. Sources: AWMF, October 2021 [24]; CIDS, June 2021 [26]; COVID-19 Advisory Ontario, May 2021 [34]; ERS, April 2021 [10]; Government of Mexico, August 2021 [35]; IDSA, November 2021 [36]; J-SSCG, September 2021 [37]; MoH Brazil, May 2021 [38]; NICE, January 2022 [8]; NIH, December 2021 [39]; SITA/SIP, May 2021 [40]; SSC, March 2021 [41]; WHO, January 2022 [9].