Remdesivir Provides Clinical Improvement in Severe COVID-19 Cases

In what has been promising ongoing news, another small study has shown remdesivir to be efficacious in a majority of severely sick coronavirus 2019 (COVID-19) patients.

In an international study, 68% of hospitalized patients who were either ventilated or on oxygen showed clinical improvement.

Jonathan Grein, MD, director, Hospital Epidemiology at Cedars Sinai, led a team of investigators who studied remdesivir for compassionate use in hospitalized patients. The study was published in the New England Journal of Medicine.

Investigators reported a clinical improvement was observed in 36 of 53 patients. Thirty of these patients were receiving ventilation and 4 were receiving oxygenation.

The studied patients came from the US, Europe, Canada, and Japan.

Using a median of 18 days, 36 patients had improved to oxygen-support class, and 17 patients of 30 who were receiving ventilation were extubated. Another 25 patients were discharged.

Seven patients died, though 6 were receiving invasive ventilation at the time.

The study’s participants were given a 10-day course of remdesivir. On the first day, they were given 200 mg intravenously, and followed-up with a daily dose of a 100 mg daily for the next 9 days.

Clinicians began sending remdesivir’s manufacturer, Gilead Sciences, compassionate use requests at the end of January this year. The study’s participants were followed from January 25 through March 7.

The antiviral was initially developed for the treatment of hepatitis C, but was not effective. It was later used for Ebola treatment. Remdesivir has also shown efficacy in nonclinical models in coronaviruses. In 2020, Gilead started studying the medication for COVID-19.

In a recent interview with Contagion®, editor-in-chief Jason Gallagher, PharmD, Clinical Professor at Temple University College of Pharmacy, shared his own one-month recap of remdesivir—seeing as he last spoke with Contagion a day prior to its EUA.

Gallagher also reviewed his own changing opinion on the drug, and how new clinical trial data has better informed its role in COVID-19 care.

“Remdesivir is not a grand slam. It’s not even a home run,” Gallagher said. “It has efficacy—I believe that.” To watch more of the interview go the video here.

For the purposes of this study, investigators acknowledged their limitations, including a smaller sized cohort, relatively shorter follow-up duration, potentially missing data due to the nature of the treatment program, a lack of information regarding 8 of the initially-treated patients, the absence of a randomized control group.

“Although the latter precludes definitive conclusions, comparisons with contemporaneous cohorts from the literature, in whom general care is expected to be consistent with that of our cohort, suggest that remdesivir may have clinical benefit in patients with severe COVID-19,” Grein and colleagues wrote.