Compassionate Use of Remdesivir for Patients with Severe Covid-19
Report on compassionate use of remdesivir with 61 severe COVID-19 patients, showing clinical improvement in 36 of 53 patients.[Gérard, Zhou]
show significantly increased risk of acute kidney injury with remdesivir.
Grein et al., 10 Apr 2020, peer-reviewed, 59 authors.
n e w e ng l a n d j o u r na l
m e dic i n e
Compassionate Use of Remdesivir
for Patients with Severe Covid-19
J. Grein, N. Ohmagari, D. Shin, G. Diaz, E. Asperges, A. Castagna, T. Feldt,
G. Green, M.L. Green, F.-X. Lescure, E. Nicastri, R. Oda, K. Yo, E. Quiros‑Roldan,
A. Studemeister, J. Redinski, S. Ahmed, J. Bernett, D. Chelliah, D. Chen,
S. Chihara, S.H. Cohen, J. Cunningham, A. D’Arminio Monforte, S. Ismail,
H. Kato, G. Lapadula, E. L’Her, T. Maeno, S. Majumder, M. Massari,
M. Mora‑Rillo, Y. Mutoh, D. Nguyen, E. Verweij, A. Zoufaly, A.O. Osinusi,
A. DeZure, Y. Zhao, L. Zhong, A. Chokkalingam, E. Elboudwarej, L. Telep,
L. Timbs, I. Henne, S. Sellers, H. Cao, S.K. Tan, L. Winterbourne, P. Desai,
R. Mera, A. Gaggar, R.P. Myers, D.M. Brainard, R. Childs, and T. Flanigan
A BS T R AC T
Remdesivir, a nucleotide analogue prodrug that inhibits viral RNA polymerases,
has shown in vitro activity against SARS-CoV-2.
We provided remdesivir on a compassionate-use basis to patients hospitalized with
Covid-19, the illness caused by infection with SARS-CoV-2. Patients were those
with confirmed SARS-CoV-2 infection who had an oxygen saturation of 94% or
less while they were breathing ambient air or who were receiving oxygen support.
Patients received a 10-day course of remdesivir, consisting of 200 mg administered
intravenously on day 1, followed by 100 mg daily for the remaining 9 days of treatment. This report is based on data from patients who received remdesivir during
the period from January 25, 2020, through March 7, 2020, and have clinical data
for at least 1 subsequent day.
The authors’ full names, academic degrees, and affiliations are listed in the Appendix. Address reprint requests to Dr.
Brainard at Gilead Sciences, 333 Lakeside
Dr., Foster City, CA 94404, or at diana
This article was published on April 10,
2020, at NEJM.org.
N Engl J Med 2020;382:2327-36.
Copyright © 2020 Massachusetts Medical Society.
Of the 61 patients who received at least one dose of remdesivir, data from 8 could
not be analyzed (including 7 patients with no post-treatment data and 1 with a
dosing error). Of the 53 patients whose data were analyzed, 22 were in the United
States, 22 in Europe or Canada, and 9 in Japan. At baseline, 30 patients (57%) were
receiving mechanical ventilation and 4 (8%) were receiving extracorporeal membrane oxygenation. During a median follow-up of 18 days, 36 patients (68%) had an
improvement in oxygen-support class, including 17 of 30 patients (57%) receiving
mechanical ventilation who were extubated. A total of 25 patients (47%) were
discharged, and 7 patients (13%) died; mortality was 18% (6 of 34) among patients
receiving invasive ventilation and 5% (1 of 19) among those not receiving invasive
In this cohort of patients hospitalized for severe Covid-19 who were treated with
compassionate-use remdesivir, clinical improvement was observed in 36 of 53 patients (68%). Measurement of efficacy will require ongoing randomized, placebocontrolled trials of remdesivir therapy. (Funded by Gilead Sciences.)
n engl j med 382;24
June 11, 2020
The New England Journal of Medicine
Copyright © 2020 Massachusetts Medical Society. All rights reserved.
n e w e ng l a n d j o u r na..
is less effective
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation. FLCCC
provide treatment protocols.