Remdesivir: Early Medication Can Prevent The Development Of Severe Pneumonia, But Does Not Reduce Viral Discharge!

- Mar 26, 2020-

The situation of the new crown epidemic is unprecedented and severe. Governments of various countries are urgently authorizing the use of potential drugs / therapies for the treatment of severe new coronary pneumonia, including antiviral drugs, antimalarial drugs, anti-inflammatory drugs, plasma during rehabilitation, blood purification technology, etc. Among these therapies, the antiviral drug from Gilead, "Hope of the People," remdesivir is the most concerned. In February of this year, the World Health Organization (WHO) voted a vote of confidence in redoxivir, saying that the drug has great potential and may be the best candidate for the treatment of new coronary pneumonia.


At present, remdesivir is playing an increasingly important role in the emergency treatment of critically ill patients through sympathetic medication and expanded access programs. remdesivir is a broad-spectrum antiviral drug and one of the earliest drugs proven to have potential for the treatment of new coronavirus pneumonia (COVID-19).

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On Thursday, the University of Chicago School of Medicine leaked some early clinical data of remdesivir , which caused an industry sensation. According to the STATnews report in the US media, the University of Chicago School of Medicine recruited 125 patients with new coronary pneumonia to participate in two phase III clinical trials of Gilead. Among them, 113 patients were critically ill, and all patients were treated with daily infusion of remdesivir . The results showed that after receiving Radecivir treatment, the fever and respiratory symptoms of these patients were quickly alleviated. Almost all patients recovered and discharged in less than one week. Only 2 of the 125 patients died.


These results were revealed by Kathleen Mullane, an infectious disease expert at the University of Chicago School of Medicine, during an internal video discussion. According to the disclosure in the video, remdesivir has an immediate effect in the treatment of new coronary pneumonia. Many patients stopped the ventilator after 1 day of treatment, the fever symptoms disappeared, and most patients only treated for 3 days. An example of treatment from a critically ill patient showed that after initiating the treatment with remdesivir , the patient had a fever subsided on day 1, stopped oxygen supplement on day 2, and was discharged from hospital on day 4! In an interview with STATnews, the patient bluntly said, "Redxive is really a miracle." At present, the whole world is waiting for the announcement of the clinical trial results in order to confirm whether the "People's Hope" remdesivir  is really so live up to expectations.


——Latest research: Early application of redoxir treatment after infection has a significant effect, which can prevent the development of severe pneumonia, but cannot reduce the virus shedding of the nose, pharynx, and rectum


Recently, an animal study conducted by the National Institutes of Health (NIH) Institute of Allergy and Infectious Diseases (NIAID) provided the latest evidence that remdesivir can effectively prevent the progression of new coronary pneumonia. The study was carried out in an animal model of rhesus monkey infected with a new coronavirus (SARS-CoV-2). The results showed that early application of remdesivir  treatment after infection has a significant clinical effect and can significantly reduce clinical disease and lung disease. Department of damage. These data support the early initiation of remdesivir treatment in patients with COVID-19 to prevent the disease from progressing to severe pneumonia. The research results were published on the preprint website bioRxiv recently. The article title is: Clinical benefit of remdesivir in rhesus macaques infected with SARS-CoV-2. 


The study was carried out by a team of scientists at NIAID and followed the administration and treatment procedures of remdesivir in hospitalized COVID-19 patients in a large-scale multicenter clinical trial led by NIAID. In the study, the team used its newly established SARS-CoV-2 infection rhesus monkey animal model that causes transient lower respiratory tract disease to evaluate the effect of redoxir treatment on the outcome of SARS-COV-2 infection. The study involved 2 groups of 6 rhesus monkeys, one group was the experimental group receiving reduxil treatment, and the other group was the untreated vehicle control group. Twelve hours after being infected with SARS-CoV-2 virus, the experimental group received intravenous infusion of redoxivir and daily intravenous infusion of remdesivir during the next 6 days, and the control group received an intravenous infusion of an equal amount of vehicle solution , And daily intravenous infusion of vehicle solution for the next 6 days.


Twelve hours after starting treatment, scientists began regular inspections and final necropsy on all animals to evaluate clinical, virological, and histological parameters to determine the effectiveness of the treatment. The results showed that the six animals in the experimental group receiving remdesivir were significantly better than the control group, and this trend continued throughout the 7-day study. Only 1 animal in the experimental group showed mild dyspnea, while all 6 animals in the control group showed shortness of breath and difficulty. The animals in the experimental group showed no signs of respiratory disease, and lung infiltration decreased on radiographs.

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In addition, compared with the control group, the viral load (measured by quantitative PCR) found in the lungs of the experimental group was significantly reduced, and SARS-CoV-2 caused less damage to the lungs of the experimental group than the control group.


The bronchoalveolar lavage fluid was taken to determine the infectious virus titer (Vero E6 cell measurement). The infectious virus titer of the experimental group was significantly lower than that of the control group 12 hours after the first treatment with remdesivir About 100 times.


On the third day of treatment, infectious virus was no longer detected in the bronchoalveolar lavage fluid of the experimental group, while the control group was still able to detect it. At the autopsy on the 7th day, the viral load in the lungs of animals treated with redoxivir was also significantly reduced, and lung tissue damage was significantly reduced.

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These results indicate that the application of ridxivir early in the treatment of SARS-CoV-2 infected rhesus monkeys has obvious clinical efficacy. These data support the early initiation of remdesivir treatment in patients with COVID-19 to prevent the progression to severe pneumonia.


However, the researchers pointed out that one thing to note is that while remdesivir treatment helps prevent pneumonia, it does not reduce virus shedding. In animals treated with remdesivir, although alveolar lavage fluid showed reduced viral replication in the lower respiratory tract, nasal, larynx, and rectal swabs showed no reduction in viral load and infectious viral titer. This finding is very important for the management of COVID-19 patients, that is, clinical improvement should not be interpreted as lack of infectivity.