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Remdesivir is an antiviral drug which was first developed in 2017 in the fight against the Ebola virus. The drug is a broad-spectrum antiviral medication which appears to be able to slow the growth of several different types of viruses.1,2
Although SARS-CoV-2 (the virus that causes COVID-19) is not in the same family as Ebolavirus (the virus that causes Ebola virus disease), remdesivir appears to have activity against it as well. Laboratory studies in cell culture and animal models show that remdesivir has activity against various coronaviruses.2 Remdesivir works in part by impeding the ability of RNA viruses to make copies of their genetic material. Without new genetic material, the virus cannot reproduce and spread to infect more cells.
Although it is too soon to know how big an impact remdesivir can make in the treatment of COVID-19, early reports are encouraging.
In late April, 2020, the U. S. National Institute of Allergy and Infectious Diseases (NIAID) announced that remdesivir treatment lead to faster time to recovery in hospitalized patients with confirmed SARS-CoV-2 infection. The median time to recovery in patients treated with remdesivir was 11 days, while patients who received standard of care alone recovered in a median of 15 days. Although there was a suggestion of a mortality benefit in the remdesivir group, that result was not statistically significant.3
Preliminary data announced on April 29th by Gilead Sciences, the company that developed remdesivir, showed that 5-day and 10-day courses of remdesivir were comparable in patients with severe COVID-19.4
An early report of 53 hospitalized patients who had received the drug was published in the New England Journal of Medicine. In this preliminary observational study, 68% of the patients treated with remdesivir improved clinically.5 However, it should be noted that this study did not have a control group with which to compare these outcomes.
However, not all trials assessing the efficacy of remdesivir in the context of CVOID-19 have shown a clear benefit.6
Further analysis of data from the NIAID trial, and results of the large, ongoing SIMPLE trial being conducted by Gilead Sciences will help clarify the efficacy and utility of remdesivir in COVID-19.
Gilead Sciences reported that they anticipate having enough remdesivir available for approximately 210,000 coronavirus treatment courses by the end of May, and that they are donating these supplies of remdesivir to hospitals for free through the month of June.7
1. Al-Tawfiq JA, Al-Homoud AH, Memish ZA. Remdesivir as a possible therapeutic option for the COVID-19. Travel Med Infect Dis. 2020 Mar 5:101615.
2. Amirian ES, Levy JK. Current knowledge about the antivirals remdesivir (GS-5734) and GS-441524 as therapeutic options for coronaviruses. One Health. 2020 Jun;9:100128.
3. Grein J, Ohmagari N, Shin D, et al. Compassionate Use of Remdesivir for Patients with Severe Covid-19. N Engl J Med. 2020 Apr 10.
Clinical Improvement and Decreased Hospitalization Time of COVID-19 using Remdesivir
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