Content of review 1, reviewed on October 01, 2020

The use of intravenous remdesivir in severe Covid-19 in this double blinded RCT was not associated with any statistically significant clinical benefits but there was reduction in time required for clinical improvement. The power of the study was low to support its results. But it was unavoidable because of lack of cases for recruitment. Hence the internal validity of the results are questionable. So there is scope for further research in the topic and the results are certainly giving insight for further research. The trial has also given insight into early use of remdesivir in Covid-19 as late use did not produce significant results in their study.

Major points: Implications in terms of results because of inadequate sample size are not explained This could have been explained . What is the meaning of the results in that situation All drugs and their combinations used with remdesivir could have been presented as sub - groups. This could create a significant outcome difference. Documentation of other drugs used or routine treatment followed in all the centres of the study is essential.

Although statistically not significant, the difference in early mortality in table 3 (less than 10 days) days was more favourable for remdesivir group compared to mortality after 10 days of symptom onset. It could mean remdesivir use could be further tested in trials in the first 10 days of hospitalisation for further research with adequate sample size with early intervention as much as possible.

Radiological progression in CT and RT-PCR CT values could also have been studied

Minor points: Presence or absence of statistically significant difference between baseline variables in table 1 and table 2 to be mentioned Keywords and analysis plan to be included in abstract

I have no conflicts of interest as Iam not associated with pharmaceutical companies. Iam also not a part of committees making decisions regarding treatment modalities.


    © 2020 the Reviewer (CC BY 4.0).


    Yeming, W., Dingyu, Z., Guanhua, D., Ronghui, D., Jianping, Z., Yang, J., Shouzhi, F., Ling, G., Zhenshun, C., Qiaofa, L., Yi, H., Guangwei, L., Ke, W., Yang, L., Huadong, L., Shuzhen, W., Shunan, R., Chengqing, Y., Chunlin, M., Yi, W., Dan, D., Feng, W., Xin, T., Xianzhi, Y., Yingchun, Y., Bing, L., Jie, Y., Wen, Y., Aili, W., Guohui, F., Fei, Z., Zhibo, L., Xiaoying, G., Jiuyang, X., Lianhan, S., Yi, Z., Lianjun, C., Tingting, G., Yan, W., Hong, Q., Yushen, J., Thomas, J., G., H. F., W., H. P., Bin, C., Chen, W. 2020. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. The Lancet.