Remdesivir and three other drugs for hospitalised patients with COVID-19: final results of the WHO Solidarity randomised trial and updated meta-analyses
Authors: Hongchao Pan, Richard Peto, Ana Maria Henao Restrepo, Marie-Pierre Preziosi, Vasee Sathiyamoorthy, Quarraisha Abdool Karim, Marissa Alejandria, César Hernàndez García, Marie-Paule Kieny, Reza Malekzadeh, Srinivas Murthy, K. Srinath Reddy, Mirta Roses Periago, Pierre Abi Hanna, Akaki Abutidze, Florence Ader, Abdullah Al-Bader, Almonther Alhasawi, Emma Allum, Adhra Al Mawali, Athari Alotaibi, Carlos Alvarez- Moreno, Sheila Appadoo, Derk Arts, Abdullah Asiri, Pål Aukrust, Andreas Barratt-Due, Abebe Genetu Bayih, Helena Beaumont, Samir Bellani, Virginia Benassi, Balram Bhargava, Mattia Branca, Heike Cappel-Porter, Nery Cerrato, Fadima Cheick Haidara, Ting Soo Chow, Nadia Como, Joe Eustace, Tamar Gabunia, Patricia García, Sheela Godbole, Eduardo Gotuzzo, Laimonas Griskevicius, Rasha Hamra, Mariam Hassan, Mohamed Hassany, David Hutton, Irmansyah Irmansyah, Ligita Jancoriene, Faryal Khamis, Jana Kirwan, Suresh Kumar, Peter Lennon, Gustavo Lopardo, Patrick Lydon, Nicola Magrini, Suzana Manevska, Oriol Manuel, Sybil McGinty, Marco Medina, Maria Lucia Mesa Rubio, Maria Consuelo Miranda Montoya, Jeremy Nel, Estevao Nunes, Markus Perola, Antonio Portoles, Menaldi Rasmin, Aun Raza, Helen Rees, Paula Reges, Chris Rogers, Kolawole Salami, Marina Salvadori, Mamatha Sauermann, Narvina Sinani, Samba Sow, Jonathan AC Sterne, Milena Stevanovikj, Evelina Tacconelli, Fernando Manuel Tavares Maltez, Mekonnen Teferi, Kari Tikkinen, Sven Trelle, Tengiz Tsertsvadze, Hala Zaid, John-Arne Røttingen, Soumya Swaminathan, Michael Ryan, Nevila Gjermeni, Esmeralda Meta, Damian Aguila, Ignacio Alonso, Marcos Altamirano, María Alvarez, Rodrigo Alzola, Veronica Arce, Patricia Arribillaga, Rafael Avila, Juan Balbuena, Laura Barcelona, José Barletta, María Benedetti, Verónica Berdiñas, Julieta Burgui, Sabrina Caimi, Juan Carrillo, Juan Carrizo, Juan Castelli, Alexis Cazaux, Flavia Cervellino, Angelo Chalco, Viviana Chediack, Eleonora Cunto, Nicolàs D'Amico, Lautaro de Vedia, Carolina Delgado, Debora Di Pilla, Miguel Díaz, Pablo Díaz Aguiar, Cecilia Domínguez, Leonor Ellero, Javier Farina, José Fernàndez, Roxana Ferreyra, María Filippi, Carolina Fogar, Pablo Frare, Celeste Giudiche, Mariana Golikow, Maria Georgina Gomez, Laura Hermida, Mariano Hurtado, Mariela Jacobo, Martin Jaume, Diego Laplume, María Lescano, Nicolàs Lista, Flavia Loiacono, Ana Belen López, Marcelo Losso, Cecilia Luna, Sergio Lupo, Leonardo Marianelli, Anabella Martin, Florencia Masciottra, Analía Mykietiuk, Lorena Orellano, Valeria Pachioli, María José Padilla, Cecilia Pallavicini, Jazmin Patroso, Luz Perez Blanco, Jose Louis Presas, Matias Provenzano, Lorena Lavera, Viviana Reichert, Florencia Riveros, Alejandra Rodríguez, María José Rolon, Carolina Salvay, María Simonetta, Alicia Sisto, Sandra Themines, Fernando Tito, Javier Toibaro, Graciela Torales, Luciano Verón, Carla Vizzotti, Alexander Egle, Richard Greil, Michael Joannidis, Antoine Altdorfer, Leila Belkhir, Vincent Fraipont, Maya Hites, Erico Arruda, Giovanni Breda, Arthur Colussi, Miran Corradi, Julio Croda, Helena Duani, Esaú João, Elizabeth Machado, Fernanda Mello, Demócrito Miranda Filho, Poliana Monteiro, Ceuci Nunes, Luiz Carlos Pereira Junior, Gustavo Pinto, Sonia Raboni, Marcelo Ramos, Leonardo Ruffing, Valdilea Santos, Tamara Souza, Melissa Medeiros, Alexandre Schwarzbold, Karim Ali, Tanweer Azher, David Bellemare, Alexandra Binnie, Sergio Borgia, Yiorgos Alexandros Cavayas, Nicholas Chagnon, Matthew Cheng, Eve Cloutier, John Conly, Cecilia Costiniuk, Nick Daneman, James Douglas, Catarina Downey, Erick Duan, Medeline Durand, Shane English, George Farjou, Evadiki Fera, Patricia Fontela, Rob Fowler, Mike Fralick, David Gregory Gamble, Anna Geagea, Jennifer Grant, Luke Harrison, Thomas Havey, Holly Hoang, Lauren Kelly, Yoav Keynan, Kosar Khwaja, Marina Klein, Christophe Kolan, Nadine Kronfli, Francois Lamontagne, Nelson Lee, Todd Lee, Rachel Lim, Alexandra Lostun, Erika MacIntyre, Isabelle Malhamé, Francois Martin-Carrier, Marlee McGuinty, Matthew Munan, Conar O'Neil, Daniel Ovakim, Jesse Papenburg, Ken Parhar, SeemaNair Parvathy, Santiago Perez-Patrigeon, Asgar Rishu, Moira Rushton, Kim Scherr, Kevin Schwartz, Makeda Semret, Micahel Silverman, Ameeta Singh, Wendy Sligl, Stephanie Smith, Ranjani Somayaji, Darrell Tan, Tuong-Vi Tran, Alain Tremblay, Jennifer Tsang, Alexis Turgeon, Erik Vakil, Jason Weatherald, Cedric Yansouni, Ryan Zarychanski, Claudia Aristizabal, Juan Bravo, Monica Caicedo, Julio Chacón, Diego Garzón, Fredy Guevara, Silvia Lozano-Gonzàlez, Hugo Macareno, Anita Montañez-Ayala, Jose Oñate, Jose Rojas-Gambasica, Fernando Rosso, Carlos Saavedra, Sandra Valderrama, Eliana Vàquiro-Herrera, Fabio Varón-Vega, Ivan Zuluaga, Amin Abdel Baki, Akram Abdelbary, Wael Abdel-Razek, Wagdi Amin, Noha Asem, Gehan Elassal, Marwa Elshesheny, Mohamed Fathy, Naglaa Fathy, Notaila Fayed, Ahmed Hammam, Sahar Hassany, Hamdy Ibrahim, Ehab Kamal, Hossam Masoud, Maryam Mohamed, Abdullah Mohamed Gouda, Ehab Moustafa, Shaimaa Okasha, Ahmed Rafik, Ahmed Said, Asmaa Sedky, Mohamed Solyman Kabil, Sara Tarek, Ahmed Tharwat, Samy Zaky, Emawayish Tesema Abegaz, Zelalem Mekonnen Bekele, Filmona Mekuria Asfaw, Netsanet Aragaw Tegegne, Miheret Fikre Teklemariam, Frehiwot Tamiru Nigusse, Daniel Legesse Achalu, Shewit Tesfagabr Weldegergs, Dawit Kebede Huluka, Addisu Birhanu Tereda, Tero Ala-Kokko, Jutta Delany, Heikki Ekroos, Riina Hankkio, Mia Haukipää, Iivo Hetemäki, Pia Holma, Ville Holmberg, Saana Horstia, Ville Jalkanen, Toni Jämsänen, Juuso Järventie, Petrus Järvinen, Ilkka Kalliala, Heikki Kauma, Tuomas Kilpeläinen, Hanna-Riikka Kreivi, Ilari Kuitunen, Satu Lamminmäki, Laura Mäkinen, Jarkko Mäntylä, Tiina Mattila, Marjukka Myllärniemi, Joni Niskanen, Taina Nykänen, Miro Nyqvist, Juuso Paajanen, Terhi Partanen, Riitta-Liisa Patovirta, Erja-Leena Paukkeri, Emmi Puusti, Andreas Renner, Emma Reponen, Sari Risku, Tuomas Rosberg, Jarno Rutanen, Petrus Säilä, Päivi Salonen, Marjatta Sinisalo, Katariina Sivenius, Susanna Tuominen, Jerone Aboab, Toni Alfaiate, Claire Andrejak, Pascal Andreu, Drifa Belhadi, Francois Benezit, Elisabeth Botelho-Nevers, Lila Bouadma, David Bougon, Kevin Bouiller, Fanny Bounes, Alexandre Boyer, Cédric Bruel, Alexandre Buffet, Charles Burdet, Charles Cazanave, Cyrille Chabertier, Rapahel Clere-Jehl, Dominique Costagliola, Johan-Victor Courjon, Flora Crockett, Francois Danion, Aline Dechanet, Jean Dellamonica, Christelle Delmas, Alpha Diallo, Felix Djossou, Clement Dubost, Axelle Dupont, Olivier Epaulard, Emmmanuel Faure, Karine Faure, Antoine Fayol, Samy Figueiredo, Claire Fougerou, Benjamin Gaborit, Rostane Gaci, Amandine Gagneux-Brunon, Sebastien Gallien, D Garot, Francois Goehringer, Didier Gruson, Olivier Hinschberger, Jean-Sebastien Hulot, Stephane Jaureguiberry, Vanessa Jean-Michel, Solen Kerneis, Antoine Kimmoun, Kada Klouche, Marie Lachatre, Karine Lacombe, Fabrice Laine, Jean Philippe Lanoix, Samira Laribi, Odile Launay, Bruno Laviolle, Vincent Le Moing, Jerome Le Pavec, David Lebeaux, Sylvie Leroy, Xavier Lescure, Marine Livrozet, Alain Makinson, Denis Malvy, Charles-Hugo Marquette, Guillaume Martin-Blondel, Julien Mayaux, Armand Mekontso Dessap, France Mentre, Noemie Mercier, Ferhat Meziani, Jean Michel Molina, Yoganaden Mootien, Bruno Mourvillier, Jean Christoph Navellou, M Noret, Nathan Peiffer- Smadja, Gilles Peytavin, Gilles Pialoux, Benoît Pilmis, Lionel Piroth, Vincent Poindron, Julien Poissy, Valerie Pourcher, Jean Pierre Quenot, Francois Raffi, Jean Reignier, Jean Christoph Richard, Céline Robert, Juliette Saillard, Naomi Sayre, Eric Senneville, Francois Stefan, Marie Capucine Tellier, Nicolas Terzi, Julien Textoris, Guillame Thiery, Jean Francois Timsit, Violaine Tolsma, Sarah Tubiana, Florent Wallet, Yazdan Yazdanpanah, Yoann Zerbib, Carlos Aguilar, Laura Erazo, Angel Fiallos, Rosbinda Figueroa, Juan Jose Flores, Lesddyy Melendez, Wendy Moncada, Ooriapadickal Cherian Abraham, Chetankumar Acharya, Vinaya Sekhar Aedula, Richa Aggarwal, Nishant Agrawal, Umang Agrawal, Abhishekh Agrawal, Mohammad Ahmad, Shubham Atal, Avinash Babu, Dalim Kumar Baidya, Amith Balachandran, Rakhee Bangar, Rakesh Bhadade, Sudhir Bhandari, Meghavi Bhapal, Pankaj Bhardwaj, Gaurav Bhati, Pradeep Bhatia, Krishnakant Bhatt, Thrilok Chander Bingi, Rohidas Borse, Vyom Buch, Dipti Chand, Ashish Chandwani, Jaykaran Charan, Mayur Chaudhari, Kirti Chaudhari, Vipul Chaudhary, Nishant Chauhan, Gaurav Chikara, Bharti Daswani, Rosemarie de Souza, Chetna Desai, Balusamy Divakar, Sujeet Divhare, Suresh Kumar Dorairajan, Naveen Dutt, Therani Rajan Ethirajan, Amit Gamit, Sweta Gamit, Mahendra Garg, Ajay Goenka, Aniket Goenka, Randeep Guleria, Paras Gupta, Nivedita Gupta, Madhur Gupta, Minal Harde, Vaibhav Ingle, Shivkumar Iyer, Vaishnavi Jamalapuram, Rangarajan Jayanthi, Rajnish Joshi, Abhijeet Kadam, Hemanth Kalakuntla, Mrunalini Kalikar, Sayali Kalme, Suchit Kamble, Ravi Kant, Bansari Kantharia, Arundhati Kashikar, Abhay Kavishvar, Choro Athipro Kayina, Pranali Kerkar, Sagar Khadanga, Sagar Khandare, Pranjali Kokate, Jayavelu Komathi, Vijay Krishnan, Jayasree Krishnan, Sumitra Krishnan, Sudha Kulur Mukhyaprana, N Kumarasamy, Sunil Mahavar, Souvik Maitra, Falguni Majumdar, Supriya Malhotra, Megha Mamulwar, Padma Malini, Vikas Marwah, Akhilesh Maurya, Kedar Mehta, Rajarao Mesipogu, Shobha Misra, Sajal Mitra, Ankit Mittal, Bharathi Mohan, Mohmmedirfan Momin, Vijaya Nag, Ramakrishnan Nagarajan, Kammili Nagmani, Uday Narlawar, Gopalakrishnan Natarajan, Neeraj Nischal, Dhananjay Ogale, Paltial Palat, Prasan Panda, Samiran Panda, Amee Pandya, Rohit Parate, Arunita Paritekar, Parvati Patel, Chetna Patel, Sunaina Patel, Vitan Patel, Deep Patel, Harshad Patel, Girish Patil, Deepu Peter, Durga Prasad, Vimlesh Purohit, Ebenezer Rabindrarajan, Lakshmiarasimhan Ranganathan, Tushara Rao, Chakradhara Rao, Chirag Rathod, Devang Raval, Avik Ray, Kamini Reddy, Sujata Rege, Ayyasamy Revathi, Dhara Roy, Saurabh Saigal, Suvarna Sane, Shashi Sangale, Krishnamoorthy Seetharaman, Poongulali Selvamuthu, Kurada Venkata Seshaiah, Benhur Shadrach, Jignesh Shah, Sonal Shah, Swati Sharma, Raman Sharma, Shrikant Sharma, Krishna Singh, Anil Singh, Arjeet Singh, Abhishek Singhai, Manish Soneja, Kapil Dev Soni, Thasneem banu Subhan, Sudharshini Subramaniam, Thambu David Sudarsanam, Ravindra Kumar Sudarsi, Dawood Suleman, Nilay Suthar, Shriraj Talati, Murlidhar Tambe, Tilak Tejomurtula, Bharatkumar Tirupakuzhi Vijayaraghavan, Anjan Trikha, Aarti Trivedi, Zarir Udwadia, Kamlesh Upadhyay, Ashwin Vasava, Damodaran Vasudevan, Rajendran Velayudham, Ramasubramanian Venkatasubramanian, Mamta Verma, Rakesh Waghmare, Anushka Waikar, Naveet Wig, Annisa Rizky Afrilia, Muhammad Amin, Dona Arlinda, Rossa Avrina, Lois Bang, Irawaty Djaharuddin, Aryan Djojo, Sri Laning Driyah, Mila Erastuti, Tetra Fajarwati, Harsini Harsini, Yovita Hartantri, Deddy Herman, Fathiyah Isbaniah, Muhammad Karyana, Indra Kusuma, Harli Amir Mahmudji, Irvan Medison, Agung Nugroho, Nurhayati Nurhayati, Cicih Opitasari, Ceva Wicaksono Pitoyo, Antonius Arditya Pradana, Sofyan Budi Raharjo, Ade Rahmaini, Yenni Risniati, Bambang Sigit Riyanto, I Gede Ketut Sajinadiyasa, Flora Eka Sari, Pompini Agustina Sitompul, Soedarsono Soedarsono, I Ketut Agus Somia, Yani Jane Sugiri, Retna Indah Sugiyono, Nugroho Harry Susanto, Armaji Kamaludi Syarif, Aris Yulianto, Mandana Afsharian, Atefehsadat Akhavi Mirab, Fatemeh Amini, Mahnaz Amini, Khalil Ansarin, Farhang Baba Mahmoodi, Parvaneh Baghaei, Fateme Barazandeh, Masomeh Bayani, Farzaneh Dastan, Soheil Ebrahimpour, Sareh Eghtesad, Mohammad Javad Fallahi, Fatemeh Fallahpoor Golmaee, Seyed Yaser Foroghi Ghomi, Mohammad Reza Ghadir, Mina Gheitani, Fereshteh Ghiasvand, Saied Hafizi Lotfabadi, Atousa Hakamifard, Shima Sadat Hashemi Madani, Ahmad Hormati, Hamed Hosseini, Alireza Janbakhsh, Mostafa Javanian, Farahnaz Joukar, Alireza Kamali, Amin Karampour, Nasim Khajavirad, Behnaz Khodabakhshi, Javad Khodadadi, Rozita Khodashahi, Somaieh Kiani Majd, Lida Mahfoozi, Behnam Mahmoodiyeh, Fariborz Mansour-Ghanaei, Feizollah Mansouri, Bita Mesgarpour, Mehdi Mesri, Haleh Mikaeili, Ronak Miladi, Mohsen Moghadami, Payam Mohamadi, Minoo Mohraz, Zeinab Mohseni Afshar, Sasan Moogahi, Seyed Alireza Mousavi Anari, Seyyed Hassan Mozaffar, Mahnaz Mozdourian, Reza Najafipour, Hamidreza Najari, Masoud Nazemiyeh, Alireza Norouzi, Aydin Pourkazemi, Hossein Poustchi, Seyedeh Naeimeh Saberhosseini, Marzieh Saberi, Niloufar Saber-Moghaddam, Anahita Sadeghi, Mahmoud Sadeghi Haddad Zavareh, Mohammad Ali Sahraian, Mehrdad Salahi, Mohammad Reza Salehi, Hossein Sarmadian, Babak Sayad, Kiana Shirani, Maria Shirvani, Daryanaz Shojaei, Mehran Shokri, Zeinab Siami, Ali Reza Sima, Alireza Soleimani, Saedeh Soltanmohammad, Payam Tabarsi, Ali Taghizadieh, Samaneh Tavassoli, Mehran Varnasseri, Siavash Vaziri, Mohammad Jaafar Yadyad, Shoeleh Yaghoubi, Yalda Yazdanpanah, Farid Yousefi, Mohammad Hossein Zamanian, Farid Zand, Elham Zare Hoseinzade, Colm Bergin, Aoife Cotter, Eoghan de Barra, Arthur Jackson, John Laffey, Cormac McCarthy, Eavan Muldoon, Corinna Sadlier, Teresa Maguire, Andrea Angheben, Francesca Bai, Alessandra Bandera, Francesco Barchiesi, Matteo Bassetti, Luca Bisi, Paolo Bonfanti, Federica Calò, Caterina Campoli, Benedetta Canovari, Amedeo Capetti, Francesco Castelli, Roberto Cauda, Antonella Cingolani, Nicolò Cocco, Nicola Coppola, Silvia Corcione, Eleonora Cremonini, Antonella d'Arminio Monforte, Katleen de Gaetano Donati, Pasquale De Nardo, Francesco Giuseppe De Rosa, Maria Degioanni, Paola Della Siega, Stefano Di Bella, Bruno Drera, Emanuele Focà, Chiara Fornabaio, Massimo Galli, Donatella Giacomazzi, Andrea Gori, Giulia Gustinetti, Francesca Iannuzzi, Blerta Kertusha, Silvia Lamonica, Miriam Lichtner, Tommaso Lupia, Roberto Luzzati, Margherita Macera, Elisabetta Menatti, Maria Merelli, Esther Merlini, Caterina Monari, Angelo Pan, Davide Pecori, Diletta Pezzani, Niccolò Riccardi, Paola Rodari, Eugenia Roldan, Pierangelo Rovere, Stefano Rusconi, Silvia Scabini, Carlo Tascini, Pierluigi Viale, Marcello Vincenzi, Paola Zuccalà, Patrizia Zucchi, Moudhi Al-Roomi, Salman Al-Sabah, Kelly Schrapp, Mahmoud Hassoun, Madonna Matar, Oussaima Dbouni, Nadine Yared, Michele Saliba, Anna Farra, Moussa Riachi, Birute Zablockiene, Jean Reuter, Therese Staub, Suhaila Ab Wahab, Chun Keat Chew, Hock Hin Chua, Pik Pin Goh, Heng Gee Lee, Chee Loon Leong, Lee Lee Low, Wen Yao Mak, Yasmin Mohamed Gani, Dzawani Muhamad, Nor Zaila Zaidan, Camilla Ducker, Ilir Demiri, Saad Aballi, Åse Berg, Bjørn Blomberg, Olav Dalgard, Anne Ma Dyrhol-Riise, Ragnhild Eiken, Gernot Ernst, Ranula Hannula, Metter Haugli, Lars Heggelund, Hedda Hoel, Dag Arne Lihaug Hoff, Aleksander Rygh Holten, Asgeir Johannessen, Trine Kåsine, Anders Benjamin Kildal, Bård Reikvam Kittang, Katerina Nezvalova-Henriksen, Inge Christoffer Olsen, Roy Bjørkolt Olsen, Nina Vibeche Skei, Hilde Skudal, Birgitte Tholin, Lars Thoresen, Marius Trøseid, Anders Tveita, Leif Vinge, Carl Magnus Ystrøm, Issa Al Jahdhami, Khalid AlNaamani, Zakariya Al Balushi, Nenad Pandak, Salma Abbas, Nasim Akhtar, Sumeyya Azam, Dilshad Begum, Sadia Hassan, Fivzia Herekar, Shahzaib Khan, Ejaz Ahmed Khan, Syed Faisal Mahmood, Nosheen Nasir, Anum Rahim, Samreen Sarfaraz, Qurat-ul-Ain Shaikh, Faisal Sultan, Usman Walayat, Erika Cecilia Agurto-Lescano, Andrés Martín Alcantara-Díaz, Ana María Alva-Correa, José Gustavo Alvarado-Moreno, Bethsabé Ángeles-Padilla, Hugo César Arbañil-Huamàn, Pool Christopher Ávila-Reyes, Johan Alexander Azañero-Haro, Luis Guillermo Barreto-Rocchetti, Jorge Marko A. Benitez-Peche, Karla Hortencia Bernal-Màlaga, Liliana Norma Cabrera-Portillo, Reynaldo Javier Carazas-Chavarry, Paloma Mariana Càrcamo, Indira Catalina Casimiro-Porras, Jhuliana Castillo-Espinoza, Jesús Norberto Chacaltana-Huarcaya, Carla Raquel Cornejo-Valdivia, Augusto Cruz-Chereque, Keith Cayetano Marcelino Del-Aguila-Torres, Erika Díaz-Chipana, Neil Flores-Valdez, Rosanna Andrea Franco-Vàsquez, Roxana Consuelo Gallegos-López, Dauma Yesenia Gastiaburú-Rodriguez, Gonzalo Ernesto Gianella-Malca, Andrés Alonso Gomero-Lopez, Luis Enrique Hercilla-Vàsquez, Miguel Ángel Hueda-Zavaleta, Claudia Vanessa Ibarcena-Llerena, Carlos Alberto Iberico-Barrera, Miguel Angel Inquilla-Castillo, Jesus Alberto Juàrez-Eyzaguirre, Manuel Laca-Barrera, Franco León-Jiménez, Carla Vanessa Luna-Wilson, German Màlaga, Ricardo Marin, Fernando Mejía-Cordero, Juan Arturo Mendoza-Laredo, Edinson Dante Meregildo-Rodríguez, Gonzalo Francisco Miranda-Manrique, Marco Olivera-Chaupis, Fatima Josefina Ortega-Monasterios, Jimmy Pedro Otazú-Ybàñez, María Angélica Paredes-Moreno, Claudia Ximena Peña-Mayorga, Olivia del Carmen Peña-Vàsquez, Alejandro Peña-Villalobos, Oscar J Ponce, Katherin Estefania Ponte-Fernandez, Jose Pro, César Miguel Quispe-Nolazco, Manuel Efrain Ramos-Samanez, Kory Mirtha Rojas-Murrugarra, Jorge Mauro Samanez-Pérez, Halbert Chrostian Sànchez-Carrillo, Epifanio Sànchez-Garavito, Ricardo Manuel Sànchez-Sevillano, Hernan Sandoval-Manrique, Gabriela Santos-Revilla, Julio Antonio Silva-Ramos, Manuel Alberto Solano-Ico, Alonso Soto, Giannilu Michelle Sotomayor-Woolcott, Ruben Kevin Arnold Tapia-Orihuela, Carmen Sara Terrazas-Obregón, Victor Francisco Terrones-Levano, Cesar Eduardo Ticona-Huaroto, Walter Torres-Ninapayta, Oscar Martin Torres-Ruiz, Dario Ugarte-Mercado, Orlando José Vargas-Anahua, Ruben Dario Vàsquez-Becerra, José Gabriel Vàsquez-Cerro, Miguel Villegas-Chiroque, Anna Larson Williams, Randi Mauricio Yauri-Lazo, Cybele Lara Abad, Silverose Ann Andales-Bacolcol, Marlon Arcegono, Jamie Arches, Mary Grace Astudillo, Emily Aventura, Arlyn Awing, Mishelle Vonnabie Bala, Jia An Bello, Peter Blanco, Jubert Benedicto, Susana Buno, Justine Cabrera, Thea Pamela Cajulao, Janice Caoili, Lina Casiple-Amsua, Victor Catambing, Inofel Chin, Ma. Bernadette Chua, Mitzi Marie Chua, Fresthel Monica Climacosa, Aileen David-Wang, Virginia De los Reyes, Gilly May Europa, Lenora Fernandez, Jorge Francisco, Gerard Garcia, Jemelyn Garcia, Maria Tarcela Gler, Marie Grace Dawn Isidro, Rozelle Jade Javier, Marion Kwek, Mary Ann Lansang, Aileen Lee, Kingbherly Li, Mark Ramon Victor Llanes, Ryan Llorin, Omar Khayyam Macadato, Anna Flor Malundo, Maria Elizabeth Mercado, Mercedes Mujeres, Marisse Nepomuceno, Katha Ngo-Sanchez, Mary Claire Orden, Maria Philina Pablo-Villamor, Ruel Dionisio Paez, Patricio Palmes, Marion Panaligan, Jenny Mae Quinivista-Yoon, Mary Shiela Ariola Ramos, Christine Ramos -Penalosa, Sheila Marie Reyes, Kathryn Roa, Arthur Dessi Roman, Minette Claire Rosario, Evalyn Roxas, Lourdes Ella Gonzales Santos, Helmar Soldevilla, Rontgene Solante, Jane Suaco, Daisy Tagarda, Issa Rufina Tang, Bob Te, Dennis Teo, Christopher John Tibayan, Ralph Elvi Villalobos, Duane Richard Ymbong, Gelza Mae Zabat, Fresthel Monica Climacosa, Maria Elizabeth Mercado, Maria Philina Pablo-Villamor, Stepanka Batkova, Orlando Cardoso, Ana-Raquel Garrote, Sara Lino, Maria-José Manata, Helder Pinheiro, Diana Póvoas, Freddy Ramirez, Diana Seixas, Assem Naji, M Al Al Gethamy, Mohammed Sami AL-Mulaify, Reem Al Maghraby, A Alrajhi, Aynaa Al Sharidi, Naif Alotaibi, F AlShaharani, Mazin Barry, Leen Ghonem, Anas Khalel, Ayman Mohammed Kharaba, Lulwah Alabdan, Mohammed Sharaf AlAbdullah, Abdullah Al Shabib, Simangele Bengu, Jacklyn Bennet, Thozama Dubula, Pauline Howell, Cloete Janse van Vuuren, Ismail Kalla, Aimee Lifson, Shaun Maasdorp, Nombulelo Magua, Vongani Maluleke, Nokuphiwa Mbhele, Nathi Mdladla, Mark Mendelson, Colin Menezes, Thando Mwelase, Maphoshane Nchabeleng, Thesla Palanee-Phillips, Victoria Parker, Mohammed Rassool, Paul Reeder, Bianca Sossen, Dewald Steyn, Merika Tsitsi, Sarah Alex van Blydenstein, Michelle Venter, Janse Van Vuuren, Jacquie Venturas, Daniel Abad Pérez, Maria José Abenza, Carolina Alarcón-Payer, Eva Armero Garrigos, Jose Ramon Arribas, Ana Ascaso, Juan Berenguer, Noemí Cabello-Clotet, Sandra Chamorro Tojeiro, Rafael Cuenca-Acevedo, Fernando de la Calle, Maria Dolores Del Toro, Beatriz Díaz Pollàn, Cristina Diez, María José Esquillor-Rodrigo, Vicente Estrada, Chiara Fanciulli, Francisco Fanjul, Lucía Fernàndez de Orueta, Adrian Ferre, Eva Maria Ferreira Pasos, Juan-Carlos Gainzarain-Arana, Felipe Garcia, Miguel García Deltoro, Ane Josune Goikoetxea Agirre, Julia Gómez Barquero, Ricardo Gomez-Huelgas, Julio Gonzàlez Moraleja, Carlos Guijarro, Felix Gutierrez, Jesús Guzmàn, Maialen Ibarguren, Jose Antonio Iribarren, Koen Jerusalem, Arturo Juan Arribas, A Lalueza, Antonio Leone, Iñigo Lopez Azkarreta, Daniel Lozano-Martin, Alfredo J Lucendo, Mariella Luengo López, JA Martín Oterino, JF Masa, Esperanza Merino, Begoña Monge-Maillo, Miguel-Angel Moran-Rodríguez, Elena Muñez Rubio, Josefa Muñoz Sanchez, Maria Jose Nuñez Orantos, Enrique Nuño, Zuriñe Ortiz-De-Zarate-Ibarra, Bàrbara Pagàn-Muñoz, José Ramón Paño-Pardo, Maria Peñaranda, Gerardo Pérez Chica, AM Pérez Fernàndez, Carmen Pérez-López, Victor Polo San Ricardo, Joseba Portu-Zapirain, Francesco Puchades, Ana Belen Rivas Paterna, Francisco F Rodríguez Vidigal, Jesus Rodríguez-Baño, Pilar Ruiz-Seco, Pablo Ryan, Ester Saez-De-Adana, Rosario Salas, Miguel Salavert Lletí, Raquel Sandoval, Carla Toyas-Miazza, Jorge Valencia, Emilio Vargas, Maria Velasco, Miguel Angel Von Wichmann, Andreas Bosshard, Alexandra Calmy, Tiago Castro, Matthias Cavassini, Olivier Clerc, Anna Conen, Nicolas Desbaillets, Florian Desgranges, Francois Duss, Stephane Emonet, Veronique Erard, Myriam Eyer, Aurélie Fayet-Mello, Yvonne Flammer, Andrée Friedl, Rosamaria Fulchini, Hansjakob Furrer, Nicolas Garin, Salome Gastberger, Michael Greiner, David Haefliger, Sebastian Haubitz, Matthias Hoffmann, Egon Isenring, Barbara Jakopp, Markus Lampert, Annalisa Marinosci, Yvonne Martin, Pierre-Auguste Petignat, Rein Jan Piso, Virginie Prendki, Jonas Rutishauser, Elisabeth Schaefer, Yvonne Schmiedel, Stefan Schwery, Elisavet Stavropoulou, Marcel Stoeckle, Veronique Suttels, Maria Christine Thurnher, Lorena van den Bogaart, Emily West, Jan Wiegand, Benedikt Wiggli
Journal: The Lancet (2022)

BackgroundThe Solidarity trial among COVID-19 inpatients has previously reported interim mortality analyses for four repurposed antiviral drugs. Lopinavir, hydroxychloroquine, and interferon (IFN)-β1a were discontinued for futility but randomisation to remdesivir continued. Here, we report the final results of Solidarity and meta-analyses of mortality in all relevant trials to date.MethodsSolidarity enrolled consenting adults (aged ≥18 years) recently hospitalised with, in the view of their doctor, definite COVID-19 and no contraindication to any of the study drugs, regardless of any other patient characteristics. Participants were randomly allocated, in equal proportions between the locally available options, to receive whichever of the four study drugs (lopinavir, hydroxychloroquine, IFN-β1a, or remdesivir) were locally available at that time or no study drug (controls). All patients also received the local standard of care. No placebos were given. The protocol-specified primary endpoint was in-hospital mortality, subdivided by disease severity. Secondary endpoints were progression to ventilation if not already ventilated, and time-to-discharge from hospital. Final log-rank and Kaplan-Meier analyses are presented for remdesivir, and are appended for all four study drugs. Meta-analyses give weighted averages of the mortality findings in this and all other randomised trials of these drugs among hospital inpatients. Solidarity is registered with ISRCTN, ISRCTN83971151, and ClinicalTrials.gov, NCT04315948.FindingsBetween March 22, 2020, and Jan 29, 2021, 14 304 potentially eligible patients were recruited from 454 hospitals in 35 countries in all six WHO regions. After the exclusion of 83 (0·6%) patients with a refuted COVID-19 diagnosis or encrypted consent not entered into the database, Solidarity enrolled 14 221 patients, including 8275 randomly allocated (1:1) either to remdesivir (ten daily infusions, unless discharged earlier) or to its control (allocated no study drug although remdesivir was locally available). Compliance was high in both groups. Overall, 602 (14·5%) of 4146 patients assigned to remdesivir died versus 643 (15·6%) of 4129 assigned to control (mortality rate ratio [RR] 0·91 [95% CI 0·82–1·02], p=0·12). Of those already ventilated, 151 (42·1%) of 359 assigned to remdesivir died versus 134 (38·6%) of 347 assigned to control (RR 1·13 [0·89–1·42], p=0·32). Of those not ventilated but on oxygen, 14·6% assigned to remdesivir died versus 16·3% assigned to control (RR 0·87 [0·76–0·99], p=0·03). Of 1730 not on oxygen initially, 2·9% assigned to remdesivir died versus 3·8% assigned to control (RR 0·76 [0·46–1·28], p=0·30). Combining all those not ventilated initially, 11·9% assigned to remdesivir died versus 13·5% assigned to control (RR 0·86 [0·76–0·98], p=0·02) and 14·1% versus 15·7% progressed to ventilation (RR 0·88 [0·77–1·00], p=0·04). The non-prespecified composite outcome of death or progression to ventilation occurred in 19·6% assigned to remdesivir versus 22·5% assigned to control (RR 0·84 [0·75–0·93], p=0·001). Allocation to daily remdesivir infusions (vs open-label control) delayed discharge by about 1 day during the 10-day treatment period. A meta-analysis of mortality in all randomised trials of remdesivir versus no remdesivir yielded similar findings.InterpretationRemdesivir has no significant effect on patients with COVID-19 who are already being ventilated. Among other hospitalised patients, it has a small effect against death or progression to ventilation (or both).FundingWHO.