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April 14, 2020 -- A small study of the antiviral drug remdesivir has shown that a majority of hospitalized patients with COVID-19 who took it improved.

The New England Journal of Medicine study showed that 36 of 53 hospitalized patients, or 68%, with severe complications got better after they took it.

That doesn’t mean they got better because they took remdesivir. The drug, which is not FDA-approved, was given to the patients for “compassionate use” and was not part of a clinical trial. It was sponsored by the drug’s maker, Gilead Sciences.

The study findings come with several caveats. The drug was not tested against a placebo, so there’s no way to know if the patients would have improved on their own. The follow-up was brief, and only 40 patients got the full 10-day treatment.

"We do not yet know if patients with COVID-19 will benefit from remdesivir, and the design of this study does not allow us to draw conclusions about who could benefit," says study lead author Jonathan Grein, MD, director of hospital epidemiology at Cedars-Sinai Medical Center, Los Angeles.

Patients ranging from 23 to 82 years old received the treatment. Thirty-six patients needed less oxygen support over a median follow-up of 18 days. Seven patients died. More than half of those on ventilation, or 17 patients, were taken off ventilation. And nearly half of those hospitalized, or 25, were discharged. Even so, "clinical improvement was less likely in those on a ventilator and those age 70 years and older," Grein says. That may reflect the underlying disease process in these patients, he says.

Remdesivir was originally developed to treat Ebola and has been shown in a lab to work against SARS-CoV-2, the virus that causes the COVID-19 infection. It is also part of several clinical trials and was recently called the “most promising” potential treatment in a study published in The Journal of the American Medical Association.

Grein says the drug works by blocking the viral genetic material (RNA) in the coronavirus from replicating.

But those laboratory findings do not always translate to findings in people, he cautions. Clinical trials are needed to see if the findings hold up.

WebMD Health News Brief Medically Reviewed by Arefa Cassoobhoy, MD, MPH on April 14, 2020

Sources

The New England Journal of Medicine: "Compassionate Use of Remdesivir for Patients with Severe Covid-19." The study was sponsored by Gilead Sciences.

Jonathan Grein, MD, director of hospital epidemiology, Cedars-Sinai Medical Center, Los Angeles.

The Journal of the American Medical Association: “Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19).”

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