Virus World

 Although several therapeutic agents have been evaluated for the treatment of coronavirus disease 2019 (Covid-19), none have yet been shown to be efficacious.  

Remdesivir sped recovery of patients by several days, although it’s “not a home run. A candidate treatment for COVID-19 has shown convincing—albeit modest—benefit for the first time in a large, carefully controlled clinical trial in hospitalized patients. The infected people who received remdesivir, an experimental drug made by Gilead Sciences that cripples an enzyme several viruses use to copy their RNA, recovered in an average of 11 days versus 15 in patients who received a placebo. “Although a 31% improvement doesn’t seem like a knockout, 100% [success], it is a very important proof of concept,” said Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases (NIAID), during an Oval Office meeting in which President Donald Trump was asked by media about a statement Gilead had released on the results. The patients treated with remdesivir also had a lower mortality rate—8% versus 11.6% in the group given the placebo—but this positive trend did not reach statistical significance, Fauci noted. (The full results from the trial have not been made public in a preprint or peer-reviewed paper.)

NIAID sponsored the study, which began on 21 February and enrolled 1063 patients at 68 sites in the United States, Europe, and Asia. A board that monitors safety and data from the trial informed investigators on 27 April that remdesivir was better than the placebo. Fauci says the board is releasing the overall results early in part on ethical grounds: Given the positive data, remdesivir must now be offered to all study participants, and trials of other treatments now underway must start to offer the drug instead of a placebo, Fauci said. The search for COVID-19 treatments that can do better than remdesivir remains a top priority. “It’s a promising signal, but we do not need to get hyperexcited—this is not a home run,” says Carlos del Rio, an infectious disease clinician at Emory University, one of the larger sites that participated in the remdesivir trial. In essence, he says, the study showed that patients who received the drug, which is given intravenously, could stop receiving supplemental oxygen earlier. Del Rio, a veteran of HIV drug development, which gradually advanced from nothing to effective treatments, hopes the results mark a first step for COVID-19. But he does not expect remdesivir will significantly ease the demands that COVID-19 is putting on hospitals, or brighten prospects for lifting shelter-in-place orders...