Remdesivir for COVID-19: “We Saw a Mortality Benefit Across Oxygen Needs”

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Remdesivir reduces COVID-19 mortality, in hospitalized patients who both did and did not require oxygen.

Mark Thrun, MD, devoted most of his career to HIV prevention, but like many infectious disease doctors, he deviated to COVID-19, and specifically remdesivir.

Remdesivir (Veklury) is a broad-spectrum antiviral medication developed by the biopharmaceutical company Gilead Sciences. During the COVID-19 pandemic, remdesivir was approved in many countries under emergency use authorization.

Thrun presented 3 remdesivir studies at this week’s 30th Conference on Retroviruses and Opportunistic Infections (CROI 2023). “It is so nice to be back with people, in real rooms talking to them in real time.”

Thrun says the primary outcome of the remdesivir trials was the “basic, but very important” outcome of mortality. He notes that remdesivir reduced the risk of mortality in COVID-19 patients both with and without severe infection.

A major distinguisher of severe COVID-19 disease was the need for oxygen. In patients who received remdesivir, “We saw that mortality benefit didn’t matter necessarily on the oxygen status,” said Thrun. “Indeed, we saw mortality benefit across oxygen needs.”

In addition to the mortality benefit, Thurn says remdesivir helped improve time to recovery, getting patients out of the hospital, as well as preventing COVID-19 resurgence to keep them out of the hospital.

“It was nice to see that this antiviral, when given appropriately early, truly made a benefit for patients,” said Thrun. Additionally, “It was pleasant to know that we’re making an impact not just on patients, but also on health care resource utilization.”

Thrun has been studying the benefits of remdesivir in COVID-19 patients for some time now, but he highlighted a recent surprise finding was how well the agent worked in immunocompromised patients. “In these patients, who we know can be even more ill than somebody who’s not immunocompromised, we see a very similar mortality benefit for those who received remdesivir early in their hospitalization.”

This is part 1 of Dr. Thrun’s interview. Come back tomorrow for part 2, in which Thrun discusses remdesivir’s ability to neutralize new and emerging COVID-19 variants.

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