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Compassionate Use of Remdesivir for Patients with Severe Covid-19

Our take —

In this case series of patients with severe COVID-19 who received Remdesivir, the majority had an improvement in oxygenation support and in a cumulative scale of clinical improvement; 23% of patients had a serious adverse event. This case series is unable to assess the impact of Remdesivir on these outcomes. Clinical trial data is needed to better understand the efficacy of Remdesivir in the treatment of COVID-19.

Study design

Case Series

Study population and setting

Description of clinical outcomes of 53 patients with severe COVID-19 who received Remdesivir through a Gilead compassionate use protocol. Patients from multiple countries were included. 40 patients (75%) were men; the median age was 64 years (interquartile range, 48 to 71); 30 patients (57%) were intubated at baseline.

Summary of Main Findings

Over a median follow-up of 18 days after receiving the first dose of Remdesivir, 36 of 53 patients (68%) showed an improvement in oxygen support, whereas 8 of 53 patients (15%) showed worsening. By 28 days of follow-up, the cumulative incidence of clinical improvement, as defined by either a decrease of 2 points or more on the six-point ordinal scale or live discharge, was 84% (95% confidence interval [CI], 70 to 99). Seven of the 53 patients (13%) died after the completion of Remdesivir, and 12 patients (23%) had serious adverse events.

Study Strengths

First published descriptive study of Remdesivir.

Limitations

This is a small case series with no comparator making it difficult to know if patients’ clinical outcomes were affected by Remdesivir. There were no defined endpoints; rather a description of the patient’s symptoms and laboratory data were given before and after the use of Remdesivir.

Value added

This paper adds to the current minimal published descriptive data on the use of Remdesivir.