BACKGROUND
Remdesivir, a nucleotide analogue prodrug that inhibits viral RNA polymerases,
has shown in vitro activity against SARS-CoV-2.
METHODS
We provided remdesivir on a compassionate-use basis to patients hospitalized with
Covid-19, the illness caused by infection with SARS-CoV-2. Patients were those
with confirmed SARS-CoV-2 infection who had an oxygen saturation of 94% or
less while they were breathing ambient air or who were receiving oxygen support.
Patients received a 10-day course of remdesivir, consisting of 200 mg administered
intravenously on day 1, followed by 100 mg daily for the remaining 9 days of treatment. This report is based on data from patients who received remdesivir during
the period from January 25, 2020, through March 7, 2020, and have clinical data
for at least 1 subsequent day.
RESULTS
Of the 61 patients who received at least one dose of remdesivir, data from 8 could
not be analyzed (including 7 patients with no post-treatment data and 1 with a
dosing error). Of the 53 patients whose data were analyzed, 22 were in the United
States, 22 in Europe or Canada, and 9 in Japan. At baseline, 30 patients (57%) were
receiving mechanical ventilation and 4 (8%) were receiving extracorporeal membrane oxygenation. During a median follow-up of 18 days, 36 patients (68%) had an
improvement in oxygen-support class, including 17 of 30 patients (57%) receiving
mechanical ventilation who were extubated. A total of 25 patients (47%) were
discharged, and 7 patients (13%) died; mortality was 18% (6 of 34) among patients
receiving invasive ventilation and 5% (1 of 19) among those not receiving invasive
ventilation.
CONCLUSIONS
In this cohort of patients hospitalized for severe Covid-19 who were treated with
compassionate-use remdesivir, clinical improvement was observed in 36 of 53 patients (68%). Measurement of efficacy will require ongoing randomized, placebocontrolled trials of remdesivir therapy. (Funded by Gilead Sciences.)
Read the whole study in NEJM
Dr. Zia H Shah, Chief Editor of the Muslim Times and in charge of health section
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