Is the antiviral drug remdesivir the new “miracle solution” to COVID-19?


A: Promising preliminary results from an uncontrolled study, but more evidence needed.

News broke late this week about results from a study at the University of Chicago of 125 COVID-19 patients, 113 of whom were severe cases. The patients in the trial were given a daily intravenous infusion of remdesivir, an antiviral medication produced by Gilead Sciences. The trial was funded by Gilead and did not include a control group (a group of patients that received an alternative medication or a placebo).

Preliminary results of this uncontrolled trial (which is ongoing at other sites) are promising: Rapid reduction in fever, reduced severity and duration of symptoms, lower mortality, etc. Promising enough that researchers eagerly await data from the other sites participating in the trial, and from other controlled studies planned or underway. Also promising enough that Gilead Sciences’ stock price soared when the U Chicago results were released.

Factors that might temper our enthusiasm? Again, it’s an uncontrolled trial (meaning we can’t compare outcomes for patients who received remdesivir to patients who received a different drug or a placebo), and ideally we’d have results from a trial that wasn’t funded by the company that makes the drug. In terms of “generalizability” (would we expect results we see here to apply broadly to other patients and setting?), it’s important to note that this trial included only patients with severe presentation of COVID-19, and the drug was delivered intravenously (hard to scale and deliver outside a healthcare setting).

Our go-to epidemiologist Dr. Marc Lipsitch from Harvard discussed the remdesivir results on WBUR radio, sounding a note of caution about this being “the solution” to COVID-19.

“Encouraging, but not definitive”, Dr. Lipsitch said. “Ending this pandemic is a lot to ask of a drug, especially one that’s used intravenously to treat relatively sick people. What it might do is reduce the severity of the pandemic so that we are less fearful of having people get infected because we have a better treatment…Even if this drug turns out to be extremely promising, it would be a big step forward, but it’s not a solution to the pandemic.”

STAT News Article