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Remdesivir use a boon for COVID patients with early use, Bengaluru study finds

Chemical structure of remdesivir. Image credit: Hbf878 / CC0
Chemical structure of remdesivir. Image credit: Hbf878 / CC0

An Indian study suggests early use of remdesivir to treat patients of COVID-19 to be beneficial, if given early. 

Remdesivir, if administered within nine days of the onset of symptoms, improves survival outcomes for those with moderate-to-severe cases of COVID-19 – the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or, simply, coronavirus. Doctors at Apollo Specialty Hospital in Jayanagar, Karnataka – a facility dedicated for the care of those with COVID-19 – conducted the study of 350 patients between June 25th and October 3rd (although four were removed from the study after developing side effects).

“Our study shows that treating patients with remdesivir within nine days from the onset of symptoms results in significant mortality benefits,” said the medicos. Of the 346 remaining participants, 260 received remdesivir within nine days. The remainder of the cohort received the drug after nine days.

Of those given the drug early, eighteen percent died. Of those who received it later, 34 percent died. “Though remdesivir was administered along with other drugs as per protocol, the other drugs were not consistent in all patients,” said Dr Ravindra Mehta, chief of pulmonology at Apollo Hospitals, who headed the study. “Early intervention of remdesivir proved significant in all other patients who survived.” He has said the research will be submitted to the Government.

Remdesivir has been a beacon of hope during the pandemic. A trial conducted by Gilead Sciences in the United States displayed promising results. According to the National Institute of Health, “remdesivir was better than placebo from the perspective of the primary endpoint, time to recovery, a metric often used in influenza trials. Recovery in this study was defined as being well enough for hospital discharge or returning to normal activity level.”

Despite the promising results, India’s Ministry of Health and Family Welfare expressed caution about the drug’s adoption. Lav Agarwal, joint secretary in the Union Ministry of Health and Family Welfare, said at the time that whilst the study did have positive outcomes but is “still inconclusive.”

The Government did go on to approve the restricted emergency remdesivir use for the treatment of moderate cases of COVID-19. Mylan received the Government’s nod to manufacture the drug in India. 

The World Health Organization (WHO), however, has cast doubt on the efficacy of remdesivir and other drugs in treatment of COVID-19. “Interim results from the Solidarity Therapeutics Trial…indicate that remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon regimens appeared to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients,” it said last month following a study conducted across more than thirty countries.

The WHO described its findings, though preliminary, as “conclusive” and “disappointingly unpromising.”

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