Is Remdesivir A Viable Option For Treating COVID-19?

Remdesivir, a nucleoside analog, works through inhibiting viral replication through competitively inhibiting viral RNA polymerase. The interesting thing about remdesivir is that it has this phosphoramidate attachment to the ribostring, which is essentially a nice way to deliver a monophosphorylated nucleoside analog intracellularly.

A new data based on patient observation has revealed that more than two-thirds of severely ill COVID-19 patients saw their condition improve after treatment with remdesivir, an experimental drug being developed by Gilead Sciences Inc.

Biotech company Gilead Sciences published an analysis in the New England Journal of Medicine on Friday tracking the responses of 53 patients with severe cases of Covid-19 to remdesivir therapy given out on a compassionate-use basis — that is, patients were given the unapproved drug because no other options are available.

The paper’s author called the findings “hopeful,” but cautioned that it is difficult to interpret the results since they do not include comparison to a control group, as would be the case in a randomized clinical trial. In addition, the patient numbers were small, the details being disclosed are limited, and the follow-up time was relatively short.

There are huge limitations on what conclusions can be drawn from this analysis. There was no randomized control group, which would have allowed the authors to compare how patients given a placebo performed relative to those given remdesivir. And the total number of patients, spread out across the United States, Canada, Europe, and Japan, is very small.

Still, the authors of the study and outside experts have described the results as reason to feel hope.

If the above study gives us reason to feel hope, there is another study which makes us less optimistic. France’s drug-safety agency has released data indicating that hydroxychloroquine, the anti-malaria drug Trump has pushed as a potential miracle drug for treating Covid-19, appears to have serious side effects on the heart when used for Covid-19 patients, and should be used under medical supervision. The report details 43 cases of “heart incidents” tied to hydroxychloroquine.

“This initial assessment shows that the risks, in particular cardiovascular, associated with these treatments are very present and potentially increased in COVID-19 patients. Almost all of the declarations come from health establishments,” the agency said.

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