Remdesivir shortens recovery time in COVID-19 patients, finds NEJM study

Preliminary results regarding the use of remdesivir against COVID-19 published in the New England Journal of Medicine reveal that Remdesivir was superior to placebo in shortening the time to recovery in adults hospitalized with Covid-19 and evidence of lower respiratory tract infection.

The study has found that hospitalized COVID-19 patients who received remdesivir recovered a median of 4 days earlier than those who received a placebo.

Although several therapeutic agents have been evaluated for the treatment of Covid-19, none have yet been shown to be efficacious.

In the study, over 1000 hospitalized patients were enrolled from Feb 21 to Apr 19 at 60 study sites and 13 subsites in the United States and Mexico (79.8%), Europe (15.3%), and Asia (4.9%), on the basis of the evolving epidemiology of the pandemic.

The Patients received either a placebo for 10 days or remdesivir intravenously as a 200-milligram (mg) loading dose followed by 100-mg maintenance doses for the next 9 days or until release from the hospital or death. The analysis includes only patients with at least some post-baseline data available.

The mean time to recovery — the primary outcome — was shorter in the remdesivir group than the placebo group (11 vs. 15 days). Recovery was defined as a patient no longer requiring hospitalization or hospitalization no longer requiring supplemental oxygen or ongoing medical care.

The authors noted that patients requiring supplemental oxygen derived the most benefit from remdesivir, while it did not benefit those requiring more intense treatments. "Our findings highlight the need to identify COVID-19 cases and start antiviral treatment before the pulmonary disease progresses to require mechanical ventilation," they wrote.

It was noted that at 14 days, mortality was 7.1% in the remdesivir group and 11.9% in the placebo group, but the difference was not statistically significant.

The authors concluded: "Our findings highlight the need to identify Covid-19 cases and start antiviral treatment before the pulmonary disease progresses to require mechanical ventilation.These preliminary findings support the use of remdesivir for patients who are hospitalized with COVID-19 and require supplemental oxygen therapy," they said. "However, given high mortality despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient."

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