Reference:
McGee, S., & De Waal, R. (2020). Rapid review of remdesivir for COVID-19: Update 15 December 2020. South African National Department of Health.
Summary:
The South African National Department of Health conducted a rapid review of remdesivir’s efficacy for treating hospitalised COVID-19 patients. The analysis included five randomised controlled trials (RCTs) with over 7,700 participants. Findings indicated that remdesivir likely has minimal impact on all-cause mortality (relative risk 0.90) and does not significantly affect ventilation needs or length of hospitalisation. The SOLIDARITY trial specifically revealed no advantage in preventing ventilation among patients not already requiring it. Furthermore, remdesivir did not increase adverse events compared to placebo. The evidence, however, remains conflicting, and the subcommittee recommended against its use in South Africa due to limited effectiveness, high costs, and accessibility issues, especially in the public health sector. The review emphasises the importance of continued research, particularly involving paediatric populations, as no data currently exists for children. The overall conclusion is that, given the current context, remdesivir should not be prioritised in treatment protocols for COVID-19 in South Africa.