Remdesivir can be very effective against coronavirus, a case study finds

LONDON: Remdesivir may be a very effective antiviral against SARS-CoV-2, the virus that causes Covid-19, according to a new monospace study that contradicts previous research that found the drug had no effect on mortality rates due to the disease.
Researchers at the University of Cambridge in the UK, who gave the drug to a patient with Covid-19 and a rare immune disease, have noticed a dramatic improvement in their symptoms and the disappearance of the virus.
Scientists have previously created hope for remdesivir, which was originally developed to treat hepatitis C and later tested against Ebola.
However, results of major clinical trials were inconclusive, and the World Health Organization (WHO) announced in October that the drug had not significantly reduced mortality rates.
The new study, published in the journal Nature Communications, used a different approach to determine the effects of the drug on Covid-19 in a closely monitored patient.
“There have been various studies supporting or questioning the effectiveness of remdesivir, but some of those done during the first wave of infection may not be optimal for evaluating its antiviral properties,” said James Thaventhiran of the University of Cambridge.
The researchers examined the case of a 31-year-old man with XLA, a rare genetic condition that affects the body’s ability to produce antibodies and therefore fight infections.
The patient’s illness began with fever, cough, nausea, and vomiting, and on day 19 he tested positive for SARS-CoV-2.
His symptoms continued and on the 30th day he was hospitalized, where he received supplemental oxygen due to breathing difficulties.
The man’s fever and pneumonia lasted more than 30 days, but without causing severe respiratory problems or spreading to other organs.
The researchers said this may have been due to his inability to produce antibodies – although antibodies fight infections, they can also cause damage to the body and even lead to severe illness.
First the patient was treated with hydroxychloroquine and azithromycin, which had little effect, and the treatments were discontinued on day 34, they said.
The patient then began a ten-day course of remdesivir.
The researchers found that within 36 hours his fever and shortness of breath improved and his nausea and vomiting ceased, adding that increasing oxygen saturation allowed him to be stripped of supplemental 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 his immune cells called lymphocytes, and chest investigations showed his lung inflammation had subsided, they said.
The patient was discharged on day 43. One week after discharge, the patient’s fever, shortness of breath, and nausea returned.
The man was admitted to hospital on day 54 and was given supplemental oxygen.
He tested positive for SARS-CoV-2 again, found lung inflammation, and his CRP levels increased and his lymphocyte count dropped.
On day 61, the patient began treatment with an additional ten-day course of remdesivir, according to the researchers.
The study found that, again, his symptoms improved rapidly, his fever dropped and he was deprived of supplemental oxygen. His CRP and lymphocyte count normalized.
After additional treatment with convalescent plasma on days 69 and 70, he was fired three days later and is no longer symptomatic.
The team found that the patient’s viral levels gradually dropped during his first course of remdesivir, in line with the improvement of his symptoms.
His virus levels increased again, as did his symptoms when the first course of treatment stopped, but the effect of the second course of remdesivir was even faster and more complete.
On day 64, he no longer tested positive for the coronavirus.
“Our patient’s unusual condition has given us rare knowledge about the effectiveness of remdesivir as a cure for coronary viral infection,” said Nicholas Matheson of the University of Cambridge.
“The dramatic response to the drug – during a repeated challenge – suggests that it can be a very effective treatment, at least for some patients,” Matheson added.
The researchers suspect that remdesvir is probably most useful when administered early in an infection before the virus is able to trigger a potentially catastrophic immune response.