Remdesivir, when compared with standard of care, has a modest but significant effect on outcomes important to patients and health systems, such as the need for mechanical ventilation.

Across 52 Canadian hospitals, we randomized 1,282 patients between Aug. 14, 2020, and Apr. 1, 2021, to remdesivir (n = 634) or standard of care (n = 648).

Of these, 15 withdrew consent or were still in hospital, for a total sample of 1267 patients.

Among patients assigned to receive remdesivir, in-hospital mortality was 18.7%, compared with 22.6% in the standard-of-care arm, and 60-day mortality was 24.8% and 28.2%, respectively.

For patients not mechanically ventilated at baseline, the need for mechanical ventilation was 8.0% in those assigned remdesivir, and 15.0% in those receiving standard of care.

Mean oxygen-free and ventilator-free days at day 28 were 15.9 and 21.4 in those receiving remdesivir and 14.2 and 19.5 in those receiving standard of care.

There was no difference in safety events of new dialysis, change in creatinine, or new hepatic dysfunction between the 2 groups.

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