Remdesivir in the treatment of COVID-19

Abstract

Cristian Dorati et al., in their article published in the Revista Argentina de Salud Pública (RASP) conclude that there is no high-quality evidence to recommend remdesivir (RDV) for the treatment of patients with coronavirus disease (COVID-19). In the same journal, Manuel Lago, concludes that the meta-analysis and the Bayesian reanalysis support the existence of a favorable effect of RDV treatment on the mortality of patients with COVID-19 pneumonia. The results of the SOLIDARITY trial, conducted by the World health Organization, do not support the suggestion that RDV can prevent a substantial fraction of all deaths. The confidence interval supports the prevention of a small fraction of all deaths, but it also supports the prevention of no deaths.
The approval of RDV by the regulatory agencies was not based on mortality data but on the evidence from the ACTT-1 study that demonstrated shorter recovery times in patients hospitalized for COVID-19. Subjects randomized to the RDV arm recovered in 10 days versus 15 days for those who received placebo. 
At times when the health system shows a high occupancy of intensive care beds, shortening the recovery time can be of great importance. Despite the absence of evidence of a decrease in mortality associated with the use of RDV, its use in hospitalized patients could offer benefits in terms of greater availability of beds. The costs of the drug are high, a reduction in them would allow a greater number of patients to be treated, thus shortening the length of hospitalization. 
More evidence needs to be generated regarding the benefits that RDV treatment can offer.