A real-life setting evaluation of the effect of remdesivir on viral load in COVID-19 patients admitted to a large tertiary centre in Israel

Abstract

Objectives The effectiveness of remdesivir, a Food and Drug Administration (FDA) approved drug for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been repeatedly questioned during the current coronavirus disease 2019 (COVID-19) pandemic. Most of the recently reported studies were randomized controlled multicenter clinical trials. Our goal was to test the efficiency of remdesivir in reducing nasopharyngeal viral load and hospitalization length in a real-life setting in admitted patients in a large tertiary center in Israel. Methods A total of 142 COVID-19 patients found to have at least three reported SARS-CoV-2 quantitative RT-PCR tests during hospitalization were selected for this study. Of these, 29 patients received remdesivir, while the remaining non-treated 113 patients served as controls. Results Among the tested parameters, the control and remdesivir groups differed significantly only in the intubation rates. Remdesivir treatment did not significantly affect nasopharyngeal viral load, as determined by comparing the differences between the first and last cycle threshold values of the SARS-CoV-2 quantitative RT-PCR tests performed during hospitalization (Ct 7.07±6.85 vs. 7.08±7.27, p=0.977 in the control and treated groups, respectively). Remdesivir treatment shortened hospitalization length by less than a day compared to non-treated controls and by 3.1 days when non-intubated patients from both groups were compared. These differences, however, were not statistically significant, possibly because of the small size of the remdesivir group. Conclusions Remdesivir was not associated with nasopharyngeal viral load changes, but our study had a significant disease severity baseline imbalance and was not powered to detect viral load or clinical differences.

The Association of Initial Viral Load among COVID-19 Patients with Sociodemographic Characteristics and Travel History in Jeddah, Kingdom of Saudi Arabia, 2020

“…Also, Wang and his colleagues suggested that the easy transmission even when symptoms are mild; could explain the efficient person-to-person transmission noted in healthcare settings; [21] that had been shown in the current study. The significant low viral load demonstrated in our cases who had fever or dyspnea, this difference is not conclusive per symptom, as it could partly be attributed to the fact that all symptomatic cases in Saudi Arabia receive imminent treatment per protocol as soon they are discovered to be positive for COVID-19; this explanation is supported by what had been asserted by several researches that the combined treatment of COVID-19 was associated with a tendency to lower viral loads and lower IgG titers which warrants assessment in larger trials [20,[22][23][24]. The non-significant relation between sociodemographic characteristics and viral load could be verified if further researches are conducted based on the successive changes in viral load rather than one point estimate [25].…”

Clinical Efficacy and Safety of Antiviral Drugs in the Extended Use against COVID-19: What We Know So Far

“…Hydroxychloroquine generated more adverse effects (47.5%) than RDV. In a real-life setting, the RDV regimen reduced hospitalization in both intubated (1.4 days lass) and non-intubated (3.4 days less) patients, although it was not statistically significant [41]. A study compared the efficacy of remdesivir, convalescent plasma, and a combination of both, which eventually revealed a higher survival rate in patients receiving RDV only [42].…”

Improving BNT162b2 mRNA vaccine tolerability without efficacy loss by Pidotimod supplementation

“…Coronavirus disease 2019 has affected hundreds of millions of people globally since it was declared. 1 Different studies on Covid-19 try to find an effective therapy for the virological phase 2,3 and the immunological phase. [4][5][6][7][8] Several vaccines have been developed to stop the spread of the virus and gain mass immunity.…”