Remdesivir: A Possible Treatment for 2019 Novel Coronavirus

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A well-known, broad-spectrum, antiviral drug appears to be the best early hope for an effective treatment of COVID-19. It is active in vitro and in animal models against SARS, MERS, and other coronaviruses. Remdesivir is not approved in any country for any use, but it is manufactured by Gilead and was stockpiled for use against Ebola, which is not a coronavirus and against which it was not particularly effective, but the drug appeared to be safe.

Two clinical trials of remdesivir are underway in China, and the National Institute of Allergy and Infectious Disease has begun a randomized controlled trial of the drug in hospitalized adults with a confirmed diagnosis of COVID-19 at the University of Nebraska Medical Center in Omaha. Gilead is apparently willing to consider compassionate use requests for other hospitalized patients with a confirmed diagnosis and significant clinical manifestations. At least one patient, who had visited Wuhan, has been treated with the drug in Washington State. On his 5th day in the hospital, the 9th day of illness, he developed radiographic and clinical signs of severe pneumonia and was treated with IV remdesivir; the next day he became afebrile and his signs and symptoms improved markedly.1 Gilead is ramping up production of the drug.

  1. ML Holshue et al. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020; 382:929.

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Comments

  1. Suzanne E. Kimball, D.O. says:

    I’m glad Medical Letter continues to be an island of calm in a sea of confusion.

  2. Carena Thompson, DO says:

    I’m trying to find information about treating fever in patients with COVID19. Only source found Lancet March 2020. PubMed down when search coronavirus. ACE2 common to SARS-CoV and COVID19, so any information about treating fever in either of those infections. Ibuprofen with ACE-Inhibitor in Diabetic patient may be more risky would only by a hypothesis. Thanks for any sources you can provide

  3. Jon Shaffer MD says:

    Please review salt water gargle/nasal rinse for prevention Covid-19. Innocuous, but effective? Should I recommend it?
    https://baledoneen.com/blog/homemade-saline-solution-that-could-help-abate-covid-19/
    Thank you.

    J. Shaffer MD
    Sugar Land, TX

  4. We will look into it and add it to our article (table is in progress). It seems reasonable and safe, as long as sterile, distilled, or boiled (and cooled) tap water is used for nasal irrigation. https://www.fda.gov/consumers/consumer-updates/rinsing-your-sinuses-neti-pots-safe

  5. Jeffrey Miller MD FACP says:

    We need a rapid small blinded study of all possible meds with equal entry criteria,such as low po2. CT infiltrates.and actual signs of rapid worsening.

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