This is why Remdesivir could be a breakthrough drug for COVID-19 patients

Until specific COVID-19 antigens and immunogens pass clinical trials, researchers are considering various ways to relieve overwhelmed medical facilities.

On balance, individuals who are mildly ill recover roughly two weeks after infection. The Center For Disease Control and Prevention advises this demographic to self-isolate, drink plenty of fluids, rest and utilize over the counter care until they have been asymptomatic for at least 14 days. Recovery windows are much more precarious for hospitalized patients.  

Typically, a patient who will make a full recovery begins to show signs of such around eight or ten days after transmission. Sadly, for reasons that are not yet known, some patients exhibit all evidence of viral clearance only to decompensate in the final stretch. Sometimes this spiral is in the form of neuropathies, cognitive disturbance, and multiple organ failure, but the vast majority of COVID-19 patients who succumb do so by reason of acute respiratory distress syndrome.  

With a pathogen as sophisticated and unpredictable as SARS-CoV-2, medical workers have to condense the amount of time the virus has to penetrate host cells. The longer it spreads its genetic material the higher the likelihood of fatal outcomes. 

Despite legislative countermeasures, increased surveillance, and supportive therapeutics, the coronavirus has eclipsed the death tolls achieved by the September 11th attacks and The Vietnam War. Irrespective of discipline, most experts agree that we have to act fast to restore a recognizable version of the systems in place before this black swan catastrophe. 

In light of these developments, emergency privileges are taking form. 

Two short days after the publication of a preliminary study premised by a National Institutes of Health–sponsored test, The U.S Food and Drug Administration has approved the use of a drug called remdesivir that disrupts the reproduction of viruses in cells. 

Remdesivir, initially developed to treat SARS and MERS patients have yielded promising results for patients enduring critical manifestations of COVID-19 as well. 

Remdesivir is a direct-acting antiviral drug that inhibits viral RNA synthesis. It is an investigational drug and is not currently approved for any indication. Remdesivir has activity in cell culture and animal models against SARS-CoV, MERS-CoV, and SARS-CoV-2,” explained the FDA’s chief scientist, Denise Hinton. “SARS-CoV-2 can cause a serious or life-threatening disease or condition, including severe respiratory illness, to humans infected by this virus. Based on the totality of scientific evidence available to FDA, it is reasonable to believe that remdesivir may be effective in treating COVID-19, and that, when used under the conditions described in this authorization, the known and potential benefits of remdesivir when used to treat COVID-19 outweigh the known and potential risks of such products.”

The Adaptive COVID-19 Treatment Trial

The researchers began their analysis with a recruited pool composed of 1,063 patients who contracted COVID-19.

The findings of the new paper echoed the strengths and shortcomings observed in a report published in the Lancet earlier this year that analyzed infected 237 participants.

Both studies revealed that administering remdesivir did not have any reductive effects on mortality for those who were severely ill but it did shorten the hospital stays for those who had the constitution to recover.

On average,  patients given placebos remained hospitalized with COVID-19 for 15 days while the experiment group was hospitalized for about 11 days.  

It should be noted that the decision to move ahead with an emergency remdesivir regimen has been met with ambivalence from a portion of the medical community.

To some, the drug’s notable side effects, which include nausea, low blood pressure, and an increase in liver enzymes studied to cause inflammation in various organs, are not justified by the modest decrease in hospital stays. 

Emergency treatment for any fast-acting illness can’t help but stumble a bit to the finish line. Remdesivir hasn’t been pitched as a miracle solution but a means to clear the table so researchers can work on cleaner protective efforts. 

“It is reasonable to believe that the known and potential benefits of remdesivir outweigh the known and potential risks of the drug for the treatment of patients hospitalized with severe COVID-19,” the authors continued. “More detailed information about the trial results, including more comprehensive data, will be available in a forthcoming report. As part of the U.S. Food and Drug Administration’s commitment to expediting the development and availability of potential COVID-19 treatments, the agency has been engaged in sustained and ongoing discussions with Gilead Sciences regarding making remdesivir available to patients as quickly as possible, as appropriate.”

The drug has also demonstrated its potential as a contributing agent in respect to viral clearance.  If remdesivir continues to consistently reduce hospital stays, its properties will be examined in relation to other confirmed therapeutics. 

CW Headley is a reporter for the Ladders and can be reached at cheadley@theladders.com