![]() ![]() The program allocated a 10-day treatment course of remdesivir, which was completed by 40 (75%) of the population 3 (6%) patients did not complete therapy because of discharge from the hospital. The majority (75%) of patients were men with a median age of 64 years (interquartile range 48–71) and symptom duration of 12 days (IQR 9–15) prior to remdesivir initiation. Notably, eight patients were excluded from the report for lack of post-baseline data or erroneous drug start date, leaving 53 evaluable patients. The series population represented all patients in the program who received their first dose of remdesivir on or before March 7, 2020, and had clinical data available for at least 1 subsequent day. Two months later, Grein and colleagues reported the safety and efficacy of compassionate use remdesivir in a case series of 61 patients from the US, Europe, Canada, and Japan. Remdesivir was initiated on symptom day 11 with improvement in clinical status the following day. The first published report of a patient with COVID-19 treated via this program describes a 35-year-old male in Snohomish County, Washington, who initially presented with mild disease but developed bilateral pneumonia requiring 2L supplemental oxygen on symptom day 10. Starting on January 25, 2020, clinicians were able to request remdesivir via a compassionate use program for any hospitalized patient with severe COVID-19, defined as either an oxygen saturation of ≤ 94% breathing ambient air or any oxygen requirement. This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors. Currently, there is no FDA-approved medication for the treatment of COVID-19. ![]() Patients represented by these data received remdesivir via a compassionate use pathway or enrollment in a clinical trial. Herein, we aim to aid clinicians in delineating the role of remdesivir for treatment of COVID-19 by critically analyzing and aggregating available, pertinent clinical data from January 1, 2020, to May 31, 2020. Since the publication of this review, results from two randomized trials evaluating remdesivir for hospitalized patients with COVID-19 were published. For a detailed discussion of pre-clinical, pharmacology, and pharmacokinetic data, the reader is directed to a recent review by Jorgensen et al. Antiviral activity is mediated by preferential incorporation of the molecule by viral RNA-dependent RNA polymerase into the RNA transcript, leading to delayed chain termination due to steric impedance. Remdesivir is a nucleoside analog prodrug with potent in vitro activity against numerous human and zoonotic coronaviruses it has also demonstrated clinical benefit in animal models of SARS-CoV, MERS-CoV, and SARS-CoV-2 infection. ![]()
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