Conflicting simultaneous report, remdesivir may accelerate recovery from severe COVID-19

Remdesivir may speed time to clinical improvement for patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, although results are conflicting, according to a study published online April 29 in The Lancet and press releases issued regarding a National Institutes of Health (NIH)-sponsored study.

Yeming Wang, M.D., from Capital Medical University in Beijing, China, and colleagues conducted a randomized trial involving 237 adults admitted to the hospital with laboratory-confirmed SARS-CoV-2 infection and radiologically confirmed pneumonia. Patients were randomly assigned in a 2:1 ratio to receive either remdesivir (158 patients) or placebo (79 patients) for 10 days. The researchers found no difference in time to clinical improvement with remdesivir (hazard ratio, 1.23; 95 percent confidence interval, 0.87 to 1.75). Among patients with a symptom duration of 10 or fewer days, though not statistically significant, there was a faster time to clinical improvement for those receiving remdesivir versus placebo (hazard ratio, 1.52; 95 percent confidence interval, 0.95 to 2.43).

In a trial sponsored by the NIH and conducted at the University of Nebraska Medical Center (UNMC)/Nebraska Medicine, 1,063 hospitalized patients with advanced COVID-19 and lung involvement were randomly assigned to receive remdesivir or placebo. Preliminary results indicated that those who received remdesivir had a 31 percent faster time to recovery compared with those receiving placebo (P < 0.001), with a median time to recovery of 11 and 15 days, respectively. A survival benefit was suggested with remdesivir, with mortality rates of 8.0 and 11.6 percent for patients receiving remdesivir and placebo, respectively (P = 0.059).

"My colleagues and I are pleased to be part of this study which is showing good preliminary results," Andre Kalil, M.D., from UNMC, said in a statement. "We all are working diligently and swiftly to do the science in the appropriate way to help in this pandemic. It also gives us hope that soon this drug may be used widely."

One author from the Wang study disclosed ties to Gilead Sciences, which manufactures remdesivir and provided the study drug.