Remdesivir: what is the evidence for its use in the treatment of COVID-19 infection?

Abstract

INTRODUCTION: Although there is a biological plausibility for the use of remdesivir in viral infections such as that caused by the new SARS-CoV-2 coronavirus, the veritable place of this medicine in COVID-19’s pandemic will be given by its therapeutic efficacy evidenced by clinical trials. The aim of this review is to analyze the scientific information available to date about the place of remdesivir in the treatment of patients with COVID-19. METHODS: a search for information on the efficacy and safety of remdesivir was performed conducted in biomedical databases, health technology evaluation reports, websites of the ministries of health, PanAmerican Health Organization and World Health Organization’s documents and drug regulatory agencies, considering the type of study, methodology, variables, end points proposed and results obtained. RESULTS: Currently, the greatest evidence comes from Adaptive COVID-19 Treatment Trial (ACTT-1) clinical trial. Preliminary results show that the average recovery time was 11 days in the remdesivir group, compared to 15 days in the placebo group. No statistically  significant difference in mortality was observed. The safety profile of remdesivir shows elevated liver enzymes, renal failure, and / or hypotension at the time of infusion. CONCLUSION: the information available to date does not provide quality evidence to recommend a routine use of remdesivir for all patients with COVID-19. New clinical trials are necessary to validate the use of this medicine in this indication.