Role of Remdesivir in treatment of Covid-19 patients, Health News, ET HealthWorld


Role of Remdesivir in treatment of Covid-19 patientsThe panic buying of antiviral Remdesivir amid the surge of Covid-19 cases is yet again seeing a discussion on the use of the drug with little or significant benefit. Debates arising looking at the Solidarity trials results, based on which the World Health Organisation had issued guidelines against the use of Remdesivir as there was little or no effect on overall mortality, mechanical ventilation and duration of hospital stay of hospitalised covid-19 patients.

The investigational broad-spectrum antiviral drug Remdesivir was initially manufactured in 2014 by biotechnology firm Gilead Sciences for targeting hepatitis C, showed potent activity against Ebola virus and Middle East Respiratory Syndrome (MERS) however it didn’t meet much success.

During the Covid-19 outbreak, the drug was found to be effective in fighting coronavirus SARS-COV-2 but in few smaller studies.

The National Institutes of Health(NIH) Adaptive COVID-19 Treatment Trial (ACTT) results found that hospitalized patients with advanced Covid-19 and lung involvement who received Remdesivir had a faster recovery time than those who received placebo.

According to medical doctors treating Covid-19 patients in India, the drug does help in reducing the viral replication however, they highlight that moderate to severe Covid-19 patients are being treated not only with Remdesivir but a combination of oxygen therapy, vitamin supplements, steroids and blood thinner at appropriate stages and that has been helping patients in recovering faster.

The most critical factor in the effectiveness of Remdesivir is when was it administered to the patient.

“Remdesivir should be used within the first 9 days from the onset of symptoms, in moderate cases or patients who are progressing from moderate to severe. It should be used only for five days, there is no point in using it for more than 5 days. There is no mortality benefit, hence it is not a magic wand however, it (Remdesivir) is the only antiviral medicine that is available right now so we need to use it properly,” said Dr. Rahul Pandit who is the Director of Critical Care Medicine and ICU at Fortis Hospital.

Given intravenously, Remdesivir interrupts the production of the virus by interfering with one of the key enzymes the virus needs to replicate RNA and this prevents the virus from multiplying. The other drugs support in bringing ease to inflammation triggered by the virus.

According to Bhatia Hospital’s Consultant Internist Dr Samrat D Shah, Remdesivir is the only sure-shot antiviral drug that reduces that viral replication. “It gives a lot of assurance that my patient is going to recover soon,” he said.

“During shortage of Remdesivir, you are relying on all other drugs to work. The treatment is incomplete when there is a combination of broad-spectrum antiviral, antibiotic, anti-inflammatory and anticoagulant. So until and unless you use this, you feel the patient is left exposed to some kind of complication,” added Dr Shah while sharing his experience of managing covid patients amid the shortage of the drug.

Speaking on the judicious use of the antiviral drug, Global Hospital’s Consultant Intensivist and Chest Physician, Dr. Harish Chafle said, “If we start the drug in the initial days of illness where the patient has consistent fever and oxygen requirement, then you definitely get a better outcome. All patients who are young and without any comorbidities, have a milder form of symptoms and do not require oxygen can be treated without Remdesivir also, it is not required to be given to all patients.”

In view of the reports of black-marketing, hoarding of the antiviral drug, and the pressure being built by the patient’s family to use Remdesivir, the government needs to provide better clarity on its use and safety guidelines.

India is currently battling with the deadly second wave which took the total Covid-19 caseload to over 1.42 crore along with some states struggling to meet the shortages in hospitals beds, oxygen, medicine and vaccine doses.

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