Adults hospitalized with COVID-19 who received the antiviral drug remdesivir early in their hospital stay experienced a measurable reduction in their risk of in-hospital death, according to two recent studies published in Clinical Infectious Diseases and Open Forum Infectious Diseases. The research examined real-world medical claims and hospital databases to evaluate the drug’s effectiveness across various patient populations and viral variants.
Survival Rates Among Patients Without Supplemental Oxygen
A large United States study published in Open Forum Infectious Diseases and led by researchers from drug developer Gilead Sciences analyzed records from December 2020 to April 2022. According to the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, the study evaluated 58,188 patients on room air who received at least one dose of remdesivir within their first two days of hospital admission, comparing them against 17,574 matched patients who did not receive the antiviral.
The data showed that 5.4% of remdesivir-treated patients and 7.3% of untreated patients died within 14 days. By 28 days, those figures rose to 8.0% and 9.8%, respectively. This translated to a statistically significant 25% reduction in the 14-day risk of death (adjusted hazard ratio [aHR], 0.75) and a 17% reduction in the 28-day risk of death (aHR, 0.83). The study period covered the predominance of pre-Delta, Delta, and Omicron variants, and researchers noted that the survival benefit held consistently across all variant eras.
Impact on Hospitalized Patients with Underlying Kidney and Liver Disease
A separate analysis published in Clinical Infectious Diseases by researchers from the University of Illinois and Gilead Sciences investigated outcomes for adults hospitalized with COVID-19 who also had pre-existing kidney or liver disease. According to the summary published by the Center for Infectious Disease Research and Policy at the University of Minnesota, the study examined medical claims data from 2021 to 2025 to determine how early antiviral administration affected high-risk cohorts.
For patients with kidney disease, early remdesivir treatment was tied to an approximate 25% lower risk of dying within 28 days compared to matched controls who did not receive the medication. Patients with liver disease experienced a comparable 24% reduction in 28-day mortality. Among patients requiring supplemental oxygen during their first two days in the hospital, the risk of 28-day in-hospital death dropped by 25% in the kidney cohort and 26% in the liver cohort among those given early remdesivir.
Evaluating Real-World Claims Data and Study Limitations
Because both analyses relied on retrospective hospital billing and insurance databases rather than randomized controlled trials, researchers and independent observers noted specific methodological limitations. Clinical claims data record diagnoses and procedures rather than granular clinical details, such as how long symptoms lasted before admission or how severe a patient appeared upon arrival.
Furthermore, because clinicians deliberately choose which patients receive antiviral therapy, treated and untreated groups may differ systematically in ways that independently influence survival rates. While statistical matching helps control for these baseline discrepancies, observational claims data cannot fully eliminate potential confounding factors.