Remdesivir shows more efficacy against COVID-19 if administered before patients require invasive ventilation

The New England Journal of Medicine has published data from the clinical trial conducted with the antiviral drug Remdesivir in patients hospitalized for Covid-19 disease. The results indicate that the drug has greater efficacy if administered to patients with pneumonia and a lack of oxygen but who do not yet require invasive ventilation.

The study, promoted by the US National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH), involved 68 hospitals, 47 in the US and 21 in Europe and Asia. It has been coordinated in Spain by the Infectious Diseases Service of the Germans Trias Hospital.

Preliminary data from the trial were released on April 29, when scientists found that Remdesivir – an antiviral initially designed against Ebola- has a clear benefit in patients and considered it unethical to maintain the placebo group.

Reducing hospitalization time

The paper presents data from 1,059 people from a randomized controlled trial, of whom 538 received Remdesivir and 521 received placebo for 10 days. Overall, the group receiving Remdesivir experienced a 31% shorter recovery time than the group receiving placebo, reducing hospitalization time by 4 days - from 15 to 11. This improvement is mainly in patients who have respiratory failure but do not require invasive or extracorporeal oxygenation.

"These results underline the need to identify COVID-19 cases as soon as possible, in order to follow up and start antiviral treatment before the lung disease progresses that invasive ventilation is required", explains Roger Paredes, MD, PhD from the Germans Trias Hospital and IrsiCaixa, who coordinated the trial in Spain.

Future strategies against SARS-CoV-2

The article also notes that patients who received the drug had a 30% reduction in mortality 14 days after beginning the study (7.1% in the Remdesivir group and 11.9% in the control group); a difference that, however, was not statistically significant. Regarding serious adverse effects, 21.1% of those who received the drug experienced them, compared to 27% in the placebo group.

Nevertheless, according to Paredes "mortality is still high, so we have to keep working. We must look for others drugs to combine to achieve even better results". "But it is a starting point, the first drug that shows efficacy and will give us many clues for future strategies against SARS-CoV-2".