In December 2019, a few patients with unexplained pneumonia were found in Wuhan, Hubei Province, China [
1]. After sequencing the genome of the virus from the patients’ lower respiratory tract in January 2020, it was found that the virus was novel coronavirus that, was not consistent with a known virus [
2]. Subsequently, the virus was officially named SARS-CoV-2 and the pneumonia was named COVID-19 [
3,
4]. As of May 27th, 2022, the number of SARS-CoV-2 infected patients worldwide has exceeded 500 million, and the death toll has reached 6.28 million [
5]. Therefore, COVID-19 is a huge hazard to human health. Although some companies have launched specific drugs to treat COVID-19 [
6,
7], their specific clinical efficacy still needs to be evaluated over the long term and at a large-scale to clarify the effects. Due to individual differences in drug metabolism and drug tolerance, a few COVID-19 drugs have difficulty meeting human needs to overcome SARS-CoV-2. Therefore, research on other broad-spectrum antiviral drugs is still indispensable. Remdesivir was once considered to be a specific drug for COVID-19, and it was quickly approved by the FDA, enabling its the use in the treatment of COVID-19 patients [
8]. When the first COVID-19 patient in the United States was being treated, remdesivir, was already used and had a good curative effect [
9]. However, several subsequent randomized controlled trial (RCT) studies showed different therapeutic effects [
10,
11]. Due to various factors, the current number of RCTs evaluating the efficacy of remdesivir in treating COVID-19 is limited. Although there are some existing meta-analyses on the efficacy of remdesivir, most of these studies have predominantly included only a limited number of existing RCTs [
12‐
16]. Consequently, the existing meta-analyses provide limited research results regarding the clinical outcomes of remdesivir, with the majority of them focusing only on a few major clinical outcomes, such as mortality, hospitalization duration, recovery rate, and adverse events [
12,
13,
15‐
17]. Additionally, most studies have analysed remdesivir’s therapeutic effects in isolation for COVID-19 and have not evaluated its combined therapeutic effects with other drugs [
12‐
17]. Besides RCTs, data from observational studies are also a crucial part of clinical evidence. Therefore, the analysis of observational studies is equally important. In this study, besides incorporating RCTs, we also include observational studies in the analysis to expand the sources of data. Moreover, we conduct meta-analyses not only on a few main outcomes but also assessed the impact of remdesivir treatment on additional clinical outcomes such as patient ventilator demand, clinical improvement, and organ damage (e.g., liver and kidney). Furthermore, we also evaluate the clinical outcomes of remdesivir in combination with other drugs. This comprehensive approach aims to thoroughly assess the clinical efficacy and safety of remdesivir in treating COVID-19 patients.