Poster layout

Title: redmesivir for the

treatment of covid-19
John H. Beigel, M.D. Kay M. Tomashek, M.D., M.P.H.
Lori E. Dodd, Ph.D.,Aneesh K. Mehta, M.D.,Barry S.
Zingman, M.D.,Andre C. Kalil, M.D., M.P.H.,Elizabeth
Hohmann, M.D.,
Helen Y. Chu, M.D., M.P.H.,

Abstract
Patients in the remdesivir group had a shorter time to
improvement of one or of two categories on the ordinal
scale from baseline than patients than patients in the
placebo group. Patients in the remdesivir group had a
shorter time to discharge Among the 913 patients
receiving oxygen at enrollment, those in the remdesivir
group continued to receive oxygen for fewer days than
patients in the placebo group.
Introduction
A novel coronavirus, severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), was first identified in
December 2019 as the cause of a respiratory illness
designated coronavirus disease 2019, or Covid-19.
Remdesivir (GS-5734), an inhibitor of the viral RNA-
dependent, RNA polymerase with in vitro inhibitory
activity against SARS-CoV-1 and the Middle East
respiratory syndrome (MERS-CoV), was identified early as
a promising therapeutic candidate for Covid-19 because
of its ability to inhibit SARS-CoV-2 in vitro. In addition, in
nonhuman primate studies, remdesivir initiated 12 hours
after inoculation with MERS-CoV reduced lung virus
levels and lung damage.

BACKGROUND
Although several therapeutic agents have been evaluated
for the treatment of coronavirus disease 2019 (Covid-19),
no antiviral agents have yet been shown to be efficacious.

METHODS
We conducted a double-blind, randomized, placebo-
controlled trial of intravenous remdesivir in adults who
were hospitalized with Covid-19 and had evidence of
lower respiratory tract infection. Patients were randomly
assigned to receive either remdesivir (200 mg loading
dose on day 1, followed by 100 mg daily for up to 9
additional days) or placebo for up to 10 days.
Results
Patients Of the 1114 patients who were assessed for
eligibility, 1062 underwent randomization; 541 were
assigned to the remdesivir group and 521 to the placebo
group (intention-to-treat population) 159 (15.0%) were
categorized as having mild-to-moderate disease, and 903
(85.0%) were in the severe disease stratum. Of those
assigned to receive remdesivir, 531 patients (98.2%)
received the treatment as assigned. Fifty-two patients had
remdesivir treatment discontinued before day 10 because
of an adverse event or a serious adverse event other than
death and 10 withdrew consent. Of those assigned to
receive placebo, 517 patients (99.2%) received placebo as
assigned. Seventy patients discontinued placebo before
day 10 because of an adverse event or a serious adverse
event other than death and 14 withdrew consent.
Discussion
Enrollment for ACTT-1 began on February 21, 2020.
Eligible patients were randomly assigned in a 1:1 ratio to
receive either remdesivir or placebo. Randomization was
stratified by study site and disease severity at enrollment.
Remdesivir was administered intravenously as a 200-mg
loading dose on day 1, followed by a 100-mg
maintenance dose administered daily on days 2 through
10 or until hospital discharge or death. A matching
placebo was administered according to the same schedule
and in the same volume as the active drug.

CONCLUSIONS
Our data show that remdesivir was superior to placebo in
shortening the time to recovery in adults who were
hospitalized with Covid-19 and had evidence of lower
respiratory tract infection.
Reference
Helmy YA, Fawzy M, Elaswad A, Sobieh A, Kenney
SP, Shehata AA. The COVID-19 pandemic: a
comprehensive review of taxonomy, genetics,
epidemiology, diagnosis, treatment, and control. J Clin
Med 2020;9(4):E1225-E1225.
Cao B, Wang Y, Wen D, et al. A trial of lopinavir–
ritonavir in adults hospitalized with severe Covid-19. N
Engl J Med 2020;382:1787-1799.
Borba MGS, Val FFA, Sampaio VS, et al. Effect of high
vs low doses of chloroquine diphosphate as adjunctive
therapy for patients hospitalized with severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2)
infections: a randomized clinical trial. JAMA Netw
Open 2020; 3(4):e208857-e208857.
The RECOVERY Collaborative Group. Dexamethasone
in hospitalized patients with Covid-19 — preliminary
report. N Engl J Med. DOI: 10.1056/NEJMoa2021436.