Is Remdesivir drug really useful in treating COVID-19?

The second wave of COVID-19 has resulted in an unprecedented rise in cases. With reports of extreme shortages of ventilator beds, medical oxygen, Remdesivir, Tocilizumab and other important medicines required emergency treatment, the country is experiencing utter chaos and despair. One drug that is making headlines these days is Remdesivir, with people now resorting to social media to source it and some even coughing large amounts of money to buy it. But why are people so desperately in need or Remdesivir, what does it do, and is it even necessary for COVID-19 treatment? Let us know here.

 

 

 

 

Remdesivir is an anti-viral drug that was manufactured in 2014 to fight the Ebola virus and the Middle East Respiratory Syndrome (MERS). It is injected intravenously and it subsumes itself into the genetic material of the virus and prevents the replicating enzyme from making new copies of the virus.

 

When the world was struck by the COVID-19 pandemic, the drug was found to be useful in fighting SARS-COV-2 and it was given authorisation for emergency-use. Remdesivir has been used indiscriminately since then which has ultimately led to a severe scarcity of the drug in India. As stated by doctors, most people don’t require the drug for surviving COVID-19 and to think that Remdesivir as a miracle cure for COVID is wrong.

 

 

 

"Use of Remdesivir for treatment of COVID has very specific indications. It is beneficial only in a very small subset (in terms of shortening the time to recovery by approximately five days) of patients early in the disease and on low-flow oxygen. Outside this group of patients, Remdesivir really is not much better than placebo for COVID", said Dr Manoj Shah in an exclusive conversation to newsbharati.com.

 

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Remdesivir was approved as the first drug to treat the virus by the US Food and Drug Administration in 2020. However, WHO says there is still no evidence that the drug is beneficial in treating hospitalised COVID-19 patients. WHO had issued a conditional recommendation against the use of remdesivir in hospitalized patients, regardless of disease severity, as there was currently no evidence that remdesivir improved survival and other outcomes in these patients. The recommendation, released on November 20, is part of a living guideline on clinical care for COVID-19. It was developed by an international guideline development group, which includes 28 clinical care experts, 4 patient-partners and one ethicist.

 

The guidelines were developed in collaboration with the non-profit Magic Evidence Ecosystem Foundation (MAGIC), which provided methodologic support. The guidelines are an innovation, matching scientific standards with the speed required to respond to an ongoing pandemic. Work on this began on 15 October when the WHO Solidarity Trial published its interim results. Data reviewed by the panel included results from this trial, as well as 3 other randomized controlled trials. In all, data from over 7000 patients across the 4 trials were considered.

 

 

The evidence suggested no important effect on mortality, need for mechanical ventilation, time to clinical improvement, and other patient-important outcomes. The guideline development group recognized that more research is needed, especially to provide higher certainty of evidence for specific groups of patients. They supported continued enrollment in trials evaluating remdesivir.

 

 

According to Dr Shah further, Remdesivir is not given to those with liver or kidney problems and it should also not be given to asymptomatic and mildly symptomatic patients while it is not required to be given to all patients.

 

 

In the past weeks, black marketing and hoarding of Remdesivir have been reported and with its scarcity, the government has limited its supply to hospitals. The drug is not supposed to be supplied to wholesale distributors or medical counters and it can not be bought over the counter as well.

 

 

India has approved the use of Remdesivir, an antiviral drug, for COVID-19 treatment. It has been listed as ‘investigational therapy’ as its benefits are still being investigated. Administered as an injection, Remdesivir helps in expediting the recovery process but cannot be used as standard care for the infected as it does not have any proven life-saving benefits. However, according to the Indian Medical Council for Research (ICMR), the intravenous drug is effective only if it is administered within the first 10 days of infection.

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