Remdesivir, hydroxychloroquine, lopinavir, and interferon beta-1 have finally little or no effect on hospitalized patients with Covid-19 and are not recommended in severe forms of the disease.

They don’t decrease the risk of mortality, the need of ventilation, and the duration of hospital stay. Those conclusions are issued after data analysis of 11,330 adults included in the Solidarity trial (including Discovery trial). They were hospitalized in 405 different hospitals in 30 countries.

In total, 1253 deaths were reported between 4 to 14 days after randomisation with a 11,8% rate of mortality at 28 days. This risk depended on several factors, particularly age (20.4% if ≥70 years and 6.2% if <50 years) and ventilation status (39.0% if the patient was already receiving ventilation at randomization and 9.5% otherwise).
Compared with the group with no trial drugs, the ones receiving remdesivir, hydroxychloroquine, lopinavir or interferon didn’t show any improvement regarding mortality or initiation of ventilation. They neither reduced the duration of hospital stay, which suggests that none of the four treatments has a pharmacologic effect to substantially reduce time to recovery. Those results were consistent overall or in any particular subgroup of age, sex, or health condition.
This trial proves the lack of efficacy for those four repurposed antivirals in reducing COVID-19 mortality, refuting early hopes for those treatments, initially based on smaller or nonrandomized studies.


Repurposed Antiviral Drugs for Covid-19 — Interim WHO Solidarity Trial Results
NEJM DOI: 10.1056/NEJMoa2023184

Antiviral drugs in hospitalized patients with COVID-19 – the DisCoVeRy trial