Remdesivir is Promising, More Answers Needed to Develop COVID-19 Treatments

With ongoing testing and increasing amounts of clinical evidence, Gilead’s remdesivir is considered a promising treatment for the coronavirus disease 2019 (COVID-19). But according to researchers, several key questions regarding the mechanics of the virus need to be answered in order to develop effective treatments.¹

Remdesivir is a nucleotide analog with broad-spectrum antiviral activity, according to Gilead Sciences Inc. Early research has found in vitro and in vivo activity in animal models against MERS and Severe Acute Respiratory Syndrome (SARS), which are closely related to COVID-19.

According to a review article published in Antimicrobial Agents and Chemotherapy, the drug was also recently tested in a nonhuman primate model of MERS-Coronavirus (CoV) infection. In that research, prophylactic treatment 24 hours prior to inoculation prevented the virus from causing clinical disease and inhibited viral replication in lung tissues.¹ It has also undergone safety testing in clinical trials for Ebola, which the authors noted would reduce the necessary time for conducted clinical trials for severe acute respiratory syndrome coronavirus (SARS-CoV-2).¹

Other therapeutic possibilities include a combination of the HIV-1 protease inhibitors lopinavir/ritonavir and interferon beta, which has shown effectiveness in patients with SARS-CoV.²

The authors noted that therapeutics targeting the coronavirus alone may not be able to reverse highly pathogenic infections, necessitating a broader approach.¹

Despite this progress, understanding how SARS-CoV-2 interacts with the host ACE2 receptor may shed light on exactly how the virus overcame the species barrier between animals and humans. Furthermore, identifying exactly which animal the virus transmitted from is necessary to prevent future human SARS-related epidemics, according to the researchers.¹

REFERENCES

• A Possible Treatment for COVID-19 and an Approval for Developing Others [news release]. American Society for Microbiology; March 11, 2020. https://asm.org/Press-Releases/2020/A-Possible-Treatment-for-COVID-19-and-an-Approach. Accessed March 30, 2020.
• Martinez M. Compounds with therapeutic potential against novel respiratory 2019 coronavirus. American Society for Microbiology; March 3, 2020. https://aac.asm.org/content/early/2020/03/03/AAC.00399-20?_ga=2.19497912.148791643.1585588986-1414625140.1585331184. Accessed March 30, 2020.