Effectiveness of Remdesivir in individuals with confirmed Omicron variant: a meta-analysis of cohort studies

The emergence of the Omicron variant (B.1.1.529) of SARS-CoV-2 represents a new challenge due to its high transmissibility and potential resistance to existing treatments. While Remdesivir, an FDA-approved antiviral, has been widely used in managing COVID-19 cases, its efficacy against the Omicron variant remains uncertain and warrants further investigation. This systematic review and meta-analysis evaluates the effectiveness of remdesivir in individuals infected with the Omicron variant. A systematic search of MEDLINE (PubMed), Embase, Cochrane Library, Google Scholar, and ClinicalTrials.gov identified relevant cohort studies. Data extraction and risk of bias assessment followed PRISMA guidelines, with statistical analysis conducted by random-effects model using the RevMan. In addition, subgroup analysis and sensitivity analysis were applied as necessary. Fourteen cohort studies with 964,156 participants were included. Remdesivir significantly reduced all-cause death among hospitalized individuals (OR: 0.70, 95% CI [0.60–0.81]), all-cause hospitalization (OR: 0.27, 95% CI [0.14–0.54]), and COVID-19-related death (OR: 0.13, 95% CI [0.03–0.58]). However, its effect on oxygen supplementation was not significant (OR: 0.52, 95% CI [0.08–3.52]). These findings reinforce the role of remdesivir in preventing severe COVID-19 outcomes among patients infected with the Omicron variant. However, this finding should be confirmed by large randomized clinical trials.