The solidarity trial is a well planned trial. The evidence given by the trial is invaluable across multiple countries. According to the results, there was no additional benefit provided independently by any of the four drugs with respect to in hospital mortality, initiation of ventilation or hospitalisation duration.

But majority (71%) of the study subjects were already requiring oxygen or ventilated at the time of study entry as shown in table 1. So clearly the benefits of these drugs in early stage of the disease was not evaluated to the full as power and sample size calculation were not pre-determined for this group of subjects. Early introduction of remdesivir have been advocated by many clinicians across the globe. The interim results failed to express the Ratio of death rates in the subgroups with lung lesions and without lung lesions.

Also wider confidence intervals of difference in RR between remdesivir and control in solidarity no O2 group in table 4 also reflects the lack of required number of subjects to give valid results.

The effect of combination of drugs was not evaluated. The local standard of care or the treatment received by the controls were not clear. As there could be potential synergistic effect of these drugs with each other or corticosteroids .

Also there was focus on clinical outcomes like duration of hospital stay , initiation of ventilation. So the criteria followed to maintain uniformity in assessing these outcomes across countries with different discharge policies was not clear.

Also it was not clear what was the criteria for discharge.

Remdesivir was an IV drug, interferon being mainly subcutaneous and other two being oral drugs, clearly there was no blinding resulting in an open trial. Pharmacokinetics of these drugs could also be affected by the status of the subjects such as ventilated or not.

The role of these drugs still needs to be investigated in mild cases or at early stage of disease by giving more focus on the time from exposure or any other criteria like CT value , biochemical evaluation and radiological evaluation along with the clinical evaluation.

Nil Conflict of interest : At present, Iam not a part of any groups making treatment decisions or clinical trials.