A Journal Club Article Review on the Study: Remdesivir in Adults with Severe COVID-19: A Randomised, Double-Blind, Placebo-Controlled, Multicentre Trial. Wang et al., 2020

The study reported the results of the first of its kind a placebo controlled randomised trial of Remdesivir in patients with severe COVID-19. The references used were recent and looked at other articles where Remdesivir was used whether in vivo or for compassionate use which gave some background to the study. In the above title study, the randomisation controlled trials (RCTs) conceptual framework was carried out, that is; assigning patients equally to the two different treatment groups. This trials has unequal ratio as 2: 1 and such unequal allocations need justification, but the rationale was not stated in this publication. Such a randomisation needs to overcome scientific and ethical problems and should always publicly declare why unequal randomisation was chosen which was not done in this study. The statistics are not simple to design and power correctly They are complex statistical concerns, and harder for non-experts to assess the statistical validity of the design. The study found that i. v. Remdesivir did not significantly improve the time to clinical improvement, mortality, or time to clearance of virus and adverse effects in patients with COVID-19 compared with placebo, though this outcomes may be affected by the unequal distribution of Comorbidities amongst the groups, gender disparity and limited Pharmacokinetics knowledge of Remdesivir in the severely ill COVID-19 patients. This study shows that Remdesivir in vivo has no clinical significance on the management of severely ill COVID-19 patients.