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Putting Remdesivir, Coronavirus Into Perspective

Why people may need to readjust their expectations around COVID-19 clinical data and drugs.

In all the data released with the newest outcomes of the SIMPLE Trial assessing differing durations of remdesivir in patients hospitalized with coronavirus 2019 (COVID-19), what caught some observers’ attention was what is still not understood.

In fact, as clinicians Raphael Dolin, MD, and Martin S. Hirsch, MD, noted in an editorial accompanying the study, SIMPLE’s broad patient population and globally-applicable ordinal scale for COVID-19 clinical improvement could be viewed as material by which further subgroup analyses could better define remdesivir’s antiviral effects.

“Analysis of the relationship between remdesivir use and clinical status may also have implications for elucidation of the pathogenesis of SARS-CoV-2,” they wrote.

Jason Gallagher, PharmD, dissented that opinion—but has his own interests in what’s still not known about the virus’ pathways.

“What’s most interesting to me right now is the area of anticoagulation, and the procoagulant effects of the virus,” he explained.

In the final part of a three-part discussion on the past month of remdesivir findings, Gallagher, Contagion Editor-in-Chief and Clinical Professor at the Temple University College of Pharmacy, concluded on where he thinks next research into the COVID-19 therapy would be best served.

Gallagher also discussed an evolving understanding of the pandemic and the virus itself—at a time when, 3 months into public health response, developing information needs to drive the next paths of assessment.

“Science constantly evolves, and our understanding evolves, and to say at any point, ‘we know this,’ and be rigid like it’s not going to change is such a huge mistake,” he said. “Somehow, we have to transmit to the public that it is a mistake to be that way, and that it’s correct to change.”