evidence: This appears to be a change from findings reported in February 2021, when preliminary trial data suggested that remdesivir "had little or no effect on patients admitted to hospital with covid-19."2 [...] The updated results, published in the Lancet, reported that overall 14.5% (602 of 4146) of patients assigned to remdesivir died compared with 15.6% (643 of 4129) assigned to the control group (mortality rate ratio 0.91, 95% confidence interval 0.82 to 1.02, P=0.12). Looking at patients who were already ventilated, 42.1% (151 of 359) assigned to remdesivir died compared with 38.6% (134 of 347) assigned to control (RR 1.13, 95% CI 0.89 to 1.42, P=0.32). For those who were not already ventilated, however, 11.9% in the remdesivir group, compared with 13.5% in the control group, died (RR 0.86, 95% CI 0.76 to 0.98, P=0.02), while 14.1% v 15.7% progressed to ventilation (RR 0.88, 95% CI 0.77 to 1.00, P=0.04).