Remdesivir: cure for COVID19 now?

Science has announced a newly discovered cure for COVID 19. That is the good news. The not-so-good news is that it merely hastens cure days,  compared to present conventional types.  But just the same, this is already a major breakthrough!   It has also its side effects.

WHAT IS REMDESIVIR?

Remdesivir is a broad-spectrum antiviral medication developed by the biopharmaceutical company Gilead Sciences. As of 2020, remdesivir is being tested as a specific treatment for COVID-19, and has been issued an Emergency Use Authorization (EUA) in the U.S. for those hospitalized with severe disease. It may shorten the time it takes to recover from the infection. Treatment is given by injection into a vein.

Earlier studies found antiviral activity against several RNA viruses including SARS coronavirus and Middle East respiratory syndrome-related coronavirus, but it is not approved for any indication.[1][2] Remdesivir was originally developed to treat Ebola virus disease and Marburg virus disease but was ineffective for these viral infections.

CHRONOLOGY OF COVID 19

As of April 2020, REMDESIVIR    was viewed as the most promising treatment for COVID-19, and was included among four treatments under evaluation in the international Solidarity trial and European Discovery trial.[25] The FDA stated on 1 May 2020 that it is “reasonable to believe” that known and potential benefits of remdesivir outweigh its known and potential risks, in some specific populations hospitalized with severe COVID19.

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On 29 April 2020, the National Institute of Allergy and Infectious Diseases (NIAID) announced that remdesivir was better than a placebo in reducing time to recovery for people hospitalized with advanced COVID19 and lung involvement. Previously data from one randomized controlled trial was released early in error and before peer review; it did not show improvement. Gilead Sciences stated that due to low enrollment the study was halted while a non-associated researcher stated it does mean if there is any benefit, then that benefit will be small.

In January 2020, Gilead began laboratory testing of remdesivir against SARS-CoV-2, stating that remdesivir had been shown to be active against severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) in animal modelsOn 21 January 2020, the Wuhan Institute of Virology applied for a Chinese “use patent”, for treating COVID19.

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In a trial in China over February-March 2020, remdesivir was not effective in reducing the time for improvement from COVID19 or deaths, and caused various adverse effects, requiring the investigators to terminate the trial.

In March 2020, a small trial of remdesivir in rhesus macaque monkeys with COVID19 infections found that it prevents disease progression.[31][32] On 18 March 2020, the World Health Organization (WHO) announced the launch of a trial that would include one group treated with remdesivir. Other clinical trials are underway or planned.

Early data from a controlled trial carried out by the US-based National Institutes of Health, suggests that remdesivir is effective in reducing the recovery time from 15 to 11 days in people seriously ill with COVID19. This data contradicted findings from a trial carried out in China, that showed remdesivir was not effective in treating COVID-19.

In April 2020, the European Medicines Agency (EMA) started a ‘rolling review’ of data on the use of remdesivir in COVID19.

Side effects

The most common adverse effects in studies of remdesivir for COVID19 include respiratory failure and blood biomarkers of organ impairment, including low albumin, low potassium, low count of red blood cells, low count of platelets that help with clotting, and yellow discoloration of the skin. Other reported side effects include gastrointestinal distress, elevated transaminase levels in the blood (liver enzymes), and infusion site reactions.

Other possible side effects of remdesivir include:

  • Infusionrelated reactions. Infusionrelated reactions have been seen during a remdesivir infusion or around the time remdesivir was given.[9]Signs and symptoms of infusionrelated reactions may include: low blood pressure, nausea, vomiting, sweating, and shivering.
  • Increases in levels of liver enzymes, seen in abnormal liver blood tests.[9]Increases in levels of liver enzymes have been seen in people who have received remdesivir, which may be a sign of inflammation or damage to cells in the liver.[9]

Research

Remdesivir was created and developed by Gilead Sciences, under the direction of scientist Tomáš Cihláø, as part of Gilead’s research and development program on treatments for Ebola virus disease and Marburg virus infections. Gilead Sciences subsequently discovered that remdesivir had antiviral activity in vitro against multiple filoviruses, pneumoviruses, paramyxoviruses, and coronaviruses.