Remdesivir offers no clinical benefit for COVID-19, extends hospital stay for many

Remdesivir offers no clinical benefit for COVID-19, extends hospital stay for many
A new study suggests remdesivir may not help those hospitalized with COVID-19, and that use of the drug extends their time in treatment. File Photo by Abhishek/UPI | License Photo

July 15 (UPI) -- Treatment with the the antiviral drug remdesivir offered no clinical benefit to patients hospitalized with COVID-19, even prolonging their stay in healthcare facilities, a study published Thursday by JAMA Network Open found.

Patients treated with the drug, which originally was developed to treat the Ebola virus, stayed in the hospital an average of roughly six days, while those who did not receive it were discharged after about three days, the data showed.


However, many of the remdesivir-treated patients may have been kept in the hospital simply to complete their course of the drug, and not because of any side effects or complications related to the treatment, the researchers said.

Still, 12% of the patients given remdesivir in the study died from COVID-19, while 11% of those who served as controls and were not treated with the drug did not survive the virus.

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"Examination of the timing of remdesivir treatment and hospital discharge suggested that clinicians were keeping some patients in the hospital simply to complete remdesivir courses, even though the patients may otherwise have been ready to leave the hospital," study co-author Dr. Michel Ohl told UPI in an email.

"The implication is that routine use of remdesivir may have led to increased use of hospital beds during the COVID-19 pandemic, without improving outcomes," said Ohl, an infectious disease specialist at the University of Iowa Hospital and Clinics in Iowa City.

Remdesivir, an antiviral drug developed during the Ebola crisis in Western Africa in 2015, has been evaluated as a possible treatment for those infected with the coronavirus in multiple clinical trials since the start of the pandemic last year.

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Most recently, a study led by the World Health Organization found that the drug failed to improve outcomes in patients hospitalized with the virus.

Because of these and other study results, the WHO recommended against its use in COVID-19 patients in November.

The U.S. Food and Drug Administration, however, already had approved remdesivir for use in people hospitalized due to severe COVID-19 only a month earlier. Former President Donald Trump, who had COVID-19 in October, is one of the U.S. patients who has been treated with the drug.

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In addition, treatment guidelines from the National Institutes of Health and the Infectious Disease Society of America still recommend its use in "severely ill" patients, particularly those struggling to breathe even on ventilator support.

For this study, Ohl and his colleagues reviewed the records of nearly 6,000 COVID-19 patients at 123 Veterans' Health Administration hospitals, about 40% of whom received remdesivir.

Those given the drug received 200 milligrams as the first treatment, followed by 100 mg. daily for either five or 10 days, the researchers said.

About 94% of the patients included in the study were men, and most were older, in their late-sixties.

Nearly half of the patients in the study were treated with the steroid dexasmethasone, which has been shown to reduce the heart and lung inflammation caused by the virus.

One in five study patients was admitted to the hospital intensive care unit as symptoms worsened, and about 6% of those treated with remdesivir required mechanical ventilation, compared with 4% in the non-remdesivir group.

"It is reasonable to use remdesivir in selected patients ... but clinicians should avoid admitting people or keeping people in hospital solely to receive [the drug] if they do not meet other criteria for hospitalization," Ohl said.


In the study, "clinicians were keeping some patients in the hospital simply to complete arbitrary five- or 10-day remdesivir courses, when they otherwise may have met criteria for discharge -- so, longer length of stay was a potential unintended consequence of the way remdesivir was used in practice," he said.

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