Remdesivir for the Treatment of Coronavirus Infection

An anti-retroviral medication called Remdesivir (Gilead Sciences) has proven to be successful at preventing the new Coronavirus from replicating at the cellular level. It is one of the three drugs that has shown promising results. Chloroquine and Ritonavir are the other two drugs. Remdesivir is currently not FDA approved. However, since the outbreak of the novel coronavirus infection in China and the impending threat to the rest of the world, research regarding its safety and efficacy has got an acceleration.

Gilead's Sciences - Remdesivir is not safe or effective for any use!

According to Gilead's Sciences, Remdesivir has not been demonstrated to be either safe or effective for any use [Ref]. Although the company has provided the drug at the request of the treating physicians and the local regulatory authorities for use in a small number of patients. Because treatment for the novel Coronavirus is not available, Remdesivir might be hopeful as it has shown to be effective in the Ebola and other Coronavirus infections. Invitro studies have documented the role of Remdesivir and Chloroquine in controlling the novel Coronavirus infections. The authors have concluded that these two agents are highly effective in vitro studies [Ref].

See more details and updates of Remdesivir here: Antiviral Medicines for COVID-19 Infection Treatment.

Why not Chloroquine or Ritonavir?

Although three drugs were found to be effectively inhibiting the coronavirus at the cellular level. Remdesivir is being thought of as the drug of choice as if it has cured many patients. Only one female patient who received Remdesivir improved within 48 hours and was discharged. Why not the rest of the patients improved? If Remdesivir is being investigated, why not the already approved and commonly used drugs chloroquine and Ritonavir being investigated?

Probably none of the three drugs is effective! 

Prevention is the key here. Proper hand hygiene, use of face masks, avoiding and isolating infected persons, and the use of hand sanitisers are the most important factors to avoid getting the infection. The above-mentioned drugs have not shown promising results in real-life patients.

Update! (22/03/2020)

Antimalarials have been incorporated into the treatment algorithm along with Remdesivir and Tocilizumab.

Most experts including experts from the Massachusettes General Hospital have published guidelines for the treatment of Coronavirus infection. All guidelines have used remdesivir, hydroxychloroquine, chloroquine, and tocilizumab depending on the severity of the patient's condition. It is also believed that antimalarial medications (such as hydroxychloroquine and chloroquine) can prevent pneumonia linked to COVID-19 and keep the illness to the upper respiratory tract. Thus, the prevention of Coronavirus infection involves the use of antimalarial medications.

Note:

This article was written during the initial days of the epidemic. The aim was to stress the use of antimalarial drugs which are too cheap, safe, and widely available drugs that could help patients. As time progressed, multiple drugs were then tested. Some of the serious patients improved with the use of Remdesivir therapy. Gilead in collaboration with other organizations including the WHO started evaluating the drug. It is now being given to patients for "compassionate use" in seriously ill patients free of cost.

Read Remdesivir details here: Antiviral Drugs for the Treatment of COVID-19 Infection

Update: 20th November: Remdesivir is not advised for individuals with COVID-19 infection by the WHO!

At one time, I wanted to delete this article as I wrote all the non-sense from time to time. However, one should have read this article at the appropriate time as guidelines evolved. Going back in time, the use of remdesivir has been discouraged by WHO. An international guideline development group, which consists of 28 clinical care specialists, 4 patient partners, and 1 ethicist, developed the most recent recommendations. Remdesivir was not recommended for therapy in individuals with COVID-19 infection, according to data from the WHO Solidarity Trial and three other randomised clinical trials. According to the WHO guideline[Ref]:

The evidence revealed there was no significant impact on patient-important outcomes like mortality, the requirement for mechanical breathing, the time it took for a clinical improvement, and others.

Comments

Dr Farhan
emedz.net@gmail.com

Thankyou for pointing out. You are right. This was what the manufacturer said when it was not a pandemic yet. However, I have updated it as guidelines have incorporated it in the treatment algorithm. https://emedz.net/coronavirus-treatment-guidelines/


David Jahimiak DDS
david@jahimiak.com

It is difficult to ignore the several recent cases of Covid-19 infected people who have recovered rapidly (1-3 days) following the administration of Remdesivir. The cases have been experimental and I have heard of no negative side effects from this drug. You imply that it may not be safe & yet I have read nothing on any experimental administration that says it is unsafe for any Covid-19 patient. It has been shown to be effective against The Corona viruses of MERS & SARS. I has not been effective on Ebola. Several cases from the Princess Cruise ship were thought to be near end of life, but after receiving Remdesivir had a relatively fast recovery. I think your article definitely deserved more internet case report research on Remdesivir