Remdesivir for 5 or 10 Days in Patients with Severe Covid-19

Goldman et al., NEJM, doi:10.1056/NEJMoa2015301, May 2020

HCQ for COVID-19

1st treatment shown to reduce risk in March 2020, now with p < 0.0000000001 from 426 studies, used in 59 countries.

No treatment is 100% effective.
Protocols combine treatments.

Study focused on remdesivir but with results for HCQ in the supplementary appendix, showing 9% death with HCQ versus 12% control, unadjusted relative risk uRR 0.78, p = 0.46.
Although the 22% lower mortality is not statistically significant, it is consistent with the significant 27% lower mortality [22‑31%] from meta-analysis of the 256 mortality results to date.
This study is excluded in the after exclusion results of meta-analysis: unadjusted results with no group details.
Study covers remdesivir and HCQ.
OutcomeImprovementEffect · pTreatmentControl
risk of death 22.3% lower · RR 0.78 · p = 0.46 22.3% lowerRR 0.78p = 0.46 10 of 109 (9.2%) 34 of 288 (11.8%) treatment 10 of 109 (9.2%), control 34 of 288 (11.8%)NNT 38

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates.

Goldman et al., 27 May 2020, retrospective, multiple countries, peer-reviewed, 26 authors.
Remdesivir for 5 or 10 Days in Patients with Severe Covid-19
M.D Jason D Goldman, M.P.H David C B Lye, B.S David S Hui, M.D Kristen M Marks, M.D Raffaele Bruno, M.D Rocio Montejano, M.D Christoph D Spinner, M.D Massimo Galli, M.D Mi-Young Ahn, M.D Ronald G Nahass, M.D Yao-Shen Chen, M.D Devi Sengupta, M.D Robert H Hyland, M.D Anu O Osinusi, M.D Huyen Cao, M.S Christiana Blair, Ph.D Xuelian Wei, M.D Anuj Gaggar, Ph.D Diana M Brainard, M.D William J Towner, M.D Jose Muñoz, M.D Kathleen M Mullane, Pharm.D Francisco M Marty, M.D Karen T Tashima, M.D George Diaz, M.D Aruna Subramanian
New England Journal of Medicine, doi:10.1056/nejmoa2015301
BACKGROUND Remdesivir is an RNA polymerase inhibitor with potent antiviral activity in vitro and efficacy in animal models of coronavirus disease 2019 (Covid-19). METHODS We conducted a randomized, open-label, phase 3 trial involving hospitalized patients with confirmed SARS-CoV-2 infection, oxygen saturation of 94% or less while they were breathing ambient air, and radiologic evidence of pneumonia. Patients were randomly assigned in a 1:1 ratio to receive intravenous remdesivir for either 5 days or 10 days. All patients received 200 mg of remdesivir on day 1 and 100 mg once daily on subsequent days. The primary end point was clinical status on day 14, assessed on a 7-point ordinal scale. RESULTS In total, 397 patients underwent randomization and began treatment (200 patients for 5 days and 197 for 10 days). The median duration of treatment was 5 days (interquartile range, 5 to 5) in the 5-day group and 9 days (interquartile range, 5 to 10) in the 10-day group. At baseline, patients randomly assigned to the 10-day group had significantly worse clinical status than those assigned to the 5-day group (P = 0.02). By day 14, a clinical improvement of 2 points or more on the ordinal scale occurred in 64% of patients in the 5-day group and in 54% in the 10-day group. After adjustment for baseline clinical status, patients in the 10-day group had a distribution in clinical status at day 14 that was similar to that among patients in the 5-day group (P = 0.14). The most common adverse events were nausea (9% of patients), worsening respiratory failure (8%), elevated alanine aminotransferase level (7%), and constipation (7%). CONCLUSIONS In patients with severe Covid-19 not requiring mechanical ventilation, our trial did not show a significant difference between a 5-day course and a 10-day course of remdesivir. With no placebo control, however, the magnitude of benefit cannot be determined.
Acute respiratory distress syndrome 1 (<1) 5 Respiratory distress 3
References
Abi-Habib, Millions had risen out of poverty. Coronavirus is pulling them back
Baden, Rubin, Covid-19 -the search for effective therapy, N Engl J Med
Beigel, Tomashek, Dodd, Remdesivir for the treatment of Covid-19 -preliminary report, N Engl J Med, doi:10.1056/NEJMoa2007764
Cao, Wang, Wen, A trial of lopinavir-ritonavir in adults hospitalized with severe Covid-19, N Engl J Med
De Wit, Feldmann, Cronin, Prophylactic and therapeutic remdesivir (GS-5734) treatment in the rhesus macaque model of MERS-CoV infection, Proc Natl Acad Sci U S A
Fauci, Lane, Redfield, Covid-19 -navigating the uncharted, N Engl J Med
Guan, Ni, Hu, Clinical characteristics of coronavirus disease 2019 in China, N Engl J Med
Mulangu, Dodd, Rt, A randomized, controlled trial of Ebola virus disease therapeutics, N Engl J Med
Norrie, Remdesivir for COVID-19: challenges of underpowered studies, Lancet
Pizzorno, Padey, Julien, Characterization and treatment of SARS-CoV-2 in nasal and bronchial human airway epithelia, doi:10.1101/2020.03.31.017889v1
Richardson, Hirsch, Narasimhan, Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area, JAMA
Romm, Mass layoffs begin in cities and states amid coronavirus fallout, threatening education, sanitation, health and safety
Sheahan, Sims, Graham, Broad-spectrum antiviral GS-5734 inhibits both epidemic and zoonotic coronaviruses, Sci Transl Med
Sheahan, Sims, Leist, Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV, Nat Commun
Spinelli, Pellino, COVID-19 pandemic: perspectives on an unfolding crisis, Br J Surg
Wang, Cao, Zhang, Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro, Cell Res
Wang, Zhang, Du, Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial, Lancet
Warren, Jordan, Lo, Therapeutic efficacy of the small molecule GS-5734 against Ebola virus in rhesus monkeys, Nature
Williamson, Feldmann, Schwarz, Clinical benefit of remdesivir in rhesus macaques infected with SARS-CoV-2, doi:10.1101/2020.04.15.043166v2
Zhang, Shi, Wang, Liver injury in COVID-19: management and challenges, Lancet Gastroenterol Hepatol
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Late treatment
is less effective