Remdesivir may reduce Covid mortality if given early: Study

Remdesivir, given within 9 days of the onset of symptoms of Covid-19, can reduce mortality in patients, according to a study in Asian patients.

Researchers at Tokyo Medical and Dental University (TMDU) found that treatment with remdesivir within 9 days of the onset of Covid-19 symptoms reduced mortality in Asian patients receiving corticosteroids.

According to the study, several studies have already shown that remdesivir can shorten the recovery time in patients with Covid-19, although there is conflicting data on whether the drug prevents patients from dying. Furthermore, previous trials have not focused on patients requiring respiratory support while in the ICU.

“Given the conflicting evidence on its survival benefit, we sought to investigate the efficacy of remdesivir versus remdesivir in Japan for covid-19,” said Mariko Hanafusa, first author of the study.

“These patients were all being treated with corticosteroids for pneumonia, and some were receiving mechanical assistance to breathe,” Hanafusa said.

Research details

According to the study, researchers analyzed the medical records of 168 patients with Covid-19 admitted to the intensive care unit at TMDU Hospital between April 2020 and November 2021.

In a study published in the Journal of Medical Virology, patients were divided into groups based on whether or not they were treated with remdesivir.

“The results showed a clear difference in survival according to the time patients were treated with remdesivir,” said lead study author Takeo Fujiwara.

“In-hospital mortality rates were significantly lower in patients treated with remdesivir and corticosteroids within 9 days of symptom onset compared with patients treated with remdesivir and corticosteroids 10 days or more after developing first symptoms,” Fujiwara said.

Analysis

A small number of patients experienced adverse events such as rash that required them to stop taking remdesivir, and more experienced acute kidney or liver injury but were able to continue treatment, the study said.

“Our findings suggest that early treatment with remdesivir and corticosteroids is associated with reduced mortality, at least in the Japanese patient population with severe and critical Covid-19,” Hanafusa said.

Given the survival benefit demonstrated in this study, time to symptom onset should be considered when using remdesivir to treat critically ill patients with Covid-19.

The different efficacy of remdesivir at different time points may reflect increasing viral load and lung injury over time and may help explain why the efficacy of this drug remains controversial.