A double-blind, randomized, placebo-controlled trial evaluated remdesivir in hospitalized adults with Covid-19 and lower respiratory tract infection. Of 1062 patients, 541 received remdesivir and 521 received placebo. The primary outcome was time to recovery, defined as discharge or hospitalization for infection control. Remdesivir reduced recovery time to 10 days (median) compared to 15 days with placebo (rate ratio 1.29; 95% CI 1.12–1.49; P<0.001). Patients receiving remdesivir were more likely to show clinical improvement by day 15 (odds ratio 1.5; 95% CI 1.2–1.9). Mortality rates by day 15 were 6.7% with remdesivir vs. 11.9% with placebo (hazard ratio 0.73; 95% CI 0.52–1.03). By day 29, mortality rates were 11.4% vs. 15.2%. Serious adverse events occurred in 24.6% of remdesivir recipients and 31.6% of placebo recipients. Remdesivir was associated with shorter recovery times, reduced hospital stays, and lower use of oxygen and mechanical ventilation. The study found remdesivir to be superior to placebo in shortening recovery time in hospitalized adults with Covid-19. The trial was funded by the National Institute of Allergy and Infectious Diseases and others. The results support the use of remdesivir in treating hospitalized patients with Covid-19.A double-blind, randomized, placebo-controlled trial evaluated remdesivir in hospitalized adults with Covid-19 and lower respiratory tract infection. Of 1062 patients, 541 received remdesivir and 521 received placebo. The primary outcome was time to recovery, defined as discharge or hospitalization for infection control. Remdesivir reduced recovery time to 10 days (median) compared to 15 days with placebo (rate ratio 1.29; 95% CI 1.12–1.49; P<0.001). Patients receiving remdesivir were more likely to show clinical improvement by day 15 (odds ratio 1.5; 95% CI 1.2–1.9). Mortality rates by day 15 were 6.7% with remdesivir vs. 11.9% with placebo (hazard ratio 0.73; 95% CI 0.52–1.03). By day 29, mortality rates were 11.4% vs. 15.2%. Serious adverse events occurred in 24.6% of remdesivir recipients and 31.6% of placebo recipients. Remdesivir was associated with shorter recovery times, reduced hospital stays, and lower use of oxygen and mechanical ventilation. The study found remdesivir to be superior to placebo in shortening recovery time in hospitalized adults with Covid-19. The trial was funded by the National Institute of Allergy and Infectious Diseases and others. The results support the use of remdesivir in treating hospitalized patients with Covid-19.