NEJM Journal Watch
By Kelly Young
Edited by Jaye Elizabeth Hefner, MD
Preliminary results regarding the use of remdesivir against novel coronavirus disease (COVID-19) have been updated and published in the New England Journal of Medicine. (An earlier accounting, which we also reported here, led to the drug’s emergency approval by the FDA.)
Over 1000 hospitalized patients with COVID-19 were randomized to receive either 10 days of remdesivir or placebo. The mean time to recovery — the primary outcome — was shorter in the remdesivir group than the placebo group (11 vs. 15 days). Recovery was defined as a patient no longer requiring hospitalization or hospitalization no longer requiring supplemental oxygen or ongoing medical care.
Results were significant only among those receiving oxygen — but not more intensive support — at baseline. At 14 days, mortality was 7.1% in the remdesivir group and 11.9% in the placebo group, but the difference was not statistically significant.
The authors write: “Our findings highlight the need to identify Covid-19 cases and start antiviral treatment before the pulmonary disease progresses to require mechanical ventilation…. However, given high mortality despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient.”