Antiviral remdesivir prevents disease progression in monkeys with COVID-19
Early treatment with the experimental antiviral drug remdesivir significantly reduced clinical disease and damage to the lungs of rhesus macaques infected with SARS-CoV-2, the coronavirus that causes COVID-19, according to National Institutes of Health scientists.
The study was designed to follow dosing and treatment procedures used for hospitalized COVID-19 patients being administered remdesivir in a large, multi-center, clinical trial led by NIH’s National Institute of Allergy and Infectious Diseases (NIAID). The scientists posted the work(link is external) on the preprint server bioRxiv. The findings are not yet peer-reviewed and should not be considered clinical advice, but are being shared to assist the public health response to COVID-19. A study detailing the development of the rhesus macaque model of mild- to-moderate human disease, conducted by the same team of NIAID scientists, was posted to bioRxiv (link is external) on March 21.
The current study of remdesivir, a drug developed by Gilead Sciences Inc. and NIAID-supported investigators, involved two groups of six rhesus macaques. One group of monkeys received remdesivir and the other animals served as an untreated comparison group. Scientists infected both groups with SARS-CoV-2. Twelve hours later the treatment group received a dose of remdesivir intravenously, and then received a daily intravenous booster dose thereafter for the next six days. The scientists timed the initial treatment to occur shortly before the virus reached its highest level in the animals’ lungs.
Twelve hours after the initial treatment, the scientists examined all animals and found the six treated animals in significantly better health than the untreated group, a trend that continued during the seven-day study. They report that one of the six treated animals showed mild breathing difficulty, whereas all six of the untreated animals showed rapid and difficult breathing. The amount of virus found in the lungs was significantly lower in the treatment group compared to the untreated group, and SARS-CoV-2 caused less damage to the lungs in treated animals than in untreated animals.
The investigators note that the data supports initiating remdesivir treatment in COVID-19 patients as early as possible to achieve maximum treatment effect. The authors, from NIAID’s Rocky Mountain Laboratories in Hamilton, Montana, also note that while remdesivir helped prevent pneumonia, it did not reduce virus shedding by the animals. “This finding is of great significance for patient management, where a clinical improvement should not be interpreted as a lack of infectiousness,” they write.
B. Williamson, et al. Clinical benefit of remdesivir in rhesus macaques infected with SARS-CoV-2(link is external).
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The efficacy of direct-acting antivirals against acute viral respiratory tract infections typically decreases with delays in treatment initation18. Thus, remdesivir treatment in COVID-19 patients should be initiated as early as possible to achieve the maximum treatment effect.
Dr Bruce Aylward, from the World Health Organization, said remdesivir was the only drug that showed any signs of effectiveness, after he visited China.
The antiviral drug was originally designed to treat Ebola, but other options proved more effective.
It has since been shown to be effective at treating other deadly coronaviruses (Middle East respiratory syndrome and severe acute respiratory syndrome) in animal studies, leading to hopes it will also be effective against the Covid-19 coronavirus.