Remdesivir can be highly effective against coronavirus, notes a case study

LONDON: Remdesivir could be a highly effective antiviral against SARS-CoV-2, the virus that causes Covid-19, according to a new single patient study that contradicts previous research that found the drug had no impact on disease mortality rates.
Researchers from the University of Cambridge in the UK who administered the drug to a patient with Covid-19 and a rare immune disease, observed a noticeable improvement in his symptoms and the disappearance of the virus.
Scientists had previously placed hope on remdesivir which was originally developed for the treatment of hepatitis C and later tested against Ebola.
However, the results of large clinical trials have been inconclusive, and the World Health Organization (WHO) announced in October that the drug did not significantly reduce death rates.
The new study, published in the journal Nature Communications, used a different approach to determine the drug’s effects on Covid-19 in a carefully monitored patient.
“There have been several studies that support or question the effectiveness of remdesivir, but some of those conducted during the first wave of infection may not be optimal for assessing its antiviral properties,” said James Thaventhiran of the University of Cambridge. .
The researchers looked at the case of a 31-year-old man with XLA, a rare genetic condition that affects the body’s ability to make antibodies and thereby fight infections.
The patient’s illness began with fever, cough, nausea, and vomiting, and he tested positive for SARS-CoV-2 on day 19.
His symptoms persisted and on day 30 he was admitted to hospital, where he was given supplemental oxygen due to breathing difficulties.
The fever and inflammation of the human lungs persisted for more than 30 days, but did not cause severe breathing problems or spread to other organs.
The researchers said this could be due to its inability to produce antibodies – although antibodies fight infections, they can also cause damage to the body and even lead to serious illness.
Initially, the patient was treated with hydroxychloroquine and azithromycin, which had little effect, and the treatments were stopped on day 34, they said.
The patient then began a ten-day course of remdesivir.
The researchers found that within 36 hours, the fever and shortness of breath had improved and the nausea and vomiting had ceased, adding that the increased oxygen saturation had allowed him to take away extra oxygen.
This dramatic clinical response was accompanied by a progressive decrease in levels of C-reactive protein (CRP), a substance produced by the liver in response to inflammation, according to the researchers.
Doctors also saw an increase in the number of her immune cells known as lymphocytes, and chest scans showed her lung inflammation was resolving, they said.
The patient was discharged on the 43rd day. A week after discharge, fever, shortness of breath and nausea returned.
The man was admitted to hospital on day 54 and given supplemental oxygen.
He tested positive for SARS-CoV-2 again, it was found that he had lung inflammation, his CRP levels had increased, and his lymphocyte count decreased.
On day 61, the patient began treatment with an additional ten-day course of remdesivir, according to the researchers.
The study found that, once again, his symptoms improved rapidly, his fever went down, and his supplemental oxygen was cut off. Her CRP and lymphocyte count normalized.
After additional convalescent plasma treatment on days 69 and 70, he was discharged three days later and is no longer symptomatic.
The team found that the patient’s virus levels progressively decreased during his first remdesivir course, corresponding to the improvement in his symptoms.
Her virus levels increased again, as did her symptoms, when the first course of treatment stopped, but the effect of the second course of remdesivir was even more rapid and complete.
By day 64, he no longer tested positive for coronavirus.
“Our patient’s unusual condition gave us a rare insight into the effectiveness of remdesivir as a treatment for coronavirus infection,” said Nicholas Matheson of the University of Cambridge.
“The dramatic response to the drug – over repeated challenges – suggests it may be a highly effective treatment, at least for some patients,” added Matheson.
Researchers suspect that remdesvir may be more useful when given early in infection, before the virus is able to trigger a potentially catastrophic immune response.