Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 5 Issue 9

Clinical Outcome of Using Remdesivir in Bangladeshi Hospitalized Patients with Severe Coronavirus Disease (COVID-19)

Md Azizul Islam1, Mohammad Azizur Rahman2, Mohammad Alimur Reza3, Mohammad Jamil A Choudhury3, KM Ashik Elahi3, Mamun Al Mahtab4* and Sheikh Mohammad Fazle Akbar5

1Directorate General of Medical Services, Bangladesh Armed Forces, Dhaka, Bangladesh
2Department of Medicine, Combined Military Hospital, Dhaka, Bangladesh
3Medical Affairs, Beximco Pharmaceuticals Ltd., Dhaka, Bangladesh
4Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
5Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan

*Corresponding Author: Mamun Al Mahtab, Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Received: July 10, 2021; Published: August 07, 2021

Abstract

Background: Remdesivir is a broad-spectrum antiviral agent that is the first and only available therapeutic drug that has been approved by several regulatory bodies for clinical use in the management of patients with severe COVID-19. Aim of this study was to evaluate the clinical outcome and safety of using Remdesivir in Bangladeshi hospitalized patients with severe COVID-19.

Methods: We conducted a randomized, controlled, open level trial of intravenous Remdesivir in adult patients who are hospitalized with Covid-19. Patients were randomly assigned to receive standard of care therapy together with Remdesivir 200 mg on day 1 followed by Remdesivir 100 mg for next 4 days or standard of care therapy only. The primary clinical endpoint was duration of hospitalization, defined by either discharge from the hospital or hospitalization for infection control purposes only.

Results: A total of 60 patients were enrolled in the study after screening. Mean age of all the patients was 53.2 ± 12.7 and 83.3% were male. Results indicated that patients in the Remdesivir group had significantly shorter mean duration of hospitalization than control group (mean ± SD 7.3 ± 2.4, as compared to 10.8 ± 6.1; p-value: 0.013). In cox proportional hazard regression comparing time to clinical improvement (TTCI), we found statistically significant difference on day 11 (HR - 1.88; 95% CI - 1.03 - 3.36; p-value - 0.038) and day 14 (HR - 2.15; 95% CI - 1.22 - 3.81; p-value - 0.008) between two groups. There was no mortality or serious adverse events among all the patients in both groups.

Conclusion: Remdesivir was proved to be beneficial to shorten the duration of hospitalization and time to clinical improvement in adult patients requiring supplemental oxygen therapy. A randomized placebo controlled clinical trial with larger sample size appears to be warranted to validate these important findings.

Keywords: COVID-19; Remdesivir; SARS-CoV-2

References

  1. Choi SW., et al. “Antiviral Activity and Safety of Remdesivir against SARS-CoV-2 Infection in Human Pluripotent Stem Cell-derived Cardiomyocytes”. Antiviral Research 184 (2020).
  2. Helmy YA., et al. “The COVID-19 Pandemic: A Comprehensive Review of Taxonomy, Genetics, Epidemiology, Diagnosis, Treatment, and Control”. Journal of Clinical Medicine 4 (2020): pii: E1225.
  3. Hui Xian J L., et al. “Remdesivir in Coronavirus Disease 2019 (COVID‑19) treatment: a review of evidence”. Infection (2021).
  4. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV) (2021).
  5. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020 (2021).
  6. Coronavirus disease (COVID-2019) Bangladesh situation reports - 21 June (2021).
  7. Cao B., et al. “A Trial of Lopinavir-Ritonavir in AdultsHospitalized with Severe Covid-19”. The New England Journal of Medicine19 (2020): 1787-1799.
  8. Malin JJ., et al. “Remdesivir against COVID-19 and Other Viral Diseases”. Clinical Microbiology Reviews (2020).
  9. Amirian ES and Levy JK. “Current knowledge about the antivirals remdesivir (GS-5734) and GS-441524 as therapeutic options for coronaviruses”. One Health (Amsterdam, Netherlands) (2020).
  10. Mulangu S., et al. “A Randomized, Controlled Trial of Ebola Virus Disease Therapeutics”. The New England Journal of Medicine24 (2019): 2293-2303.
  11. Abinit S., et al. “Probable Molecular Mechanism of Remdesivir for the Treatment of COVID-19: Need to Know More”. Archives of Medical Research 51 (2020): 585-586.
  12. US Food and Drug Administration. Coronavirus (COVID-19) update: FDA issues emergency use authorization for potential COVID-19 treatment (2020).
  13. Sheahan TP., et al. “Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV”. Nature Communication1 (2020): 222.
  14. Agostini ML., et al. “Coronavirus Susceptibility to the Antiviral Remdesivir (GS-5734) Is Mediated by the Viral Polymerase and the Proofreading Exoribonuclease”. mBio2 (2018): pii: e00221-18.
  15. Wang M., et al. “Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro”. Cell Research3 (2020): 269-271.
  16. Brown AJ., et al. “Broad spectrum antiviral remdesivir inhibits human endemic and zoonotic deltacoronaviruses with a highlydivergent RNA dependent RNA polymerase”. Antiviral Research 169 (2019): 104541.
  17. JH Beigel., et al. “Remdesivir for the Treatment of Covid-19 — Final Report”. The New England Journal of Medicine 383 (2020): 1813-1826.
  18. Alejandro S., et al. “Impact of Remdesivir on the Treatment of COVID-19 During the First Wave in Spain”. Advances in Therapy (2021).
  19. M Nasir., et al. “Survival and Biomarkers of COVID-19 Patients Treated with Remdesivir and Favipiravir in ICU during the Peak of Pandemic: A Single Center Study in Bangladesh”. Journal of Pharmaceutical Research International45 (2020): 14-22.
  20. , et al. “Present scenario of COVID-19 in Bangladesh and government preparedness for facing challenges”. Journal of Advanced Biotechnology and Experimental Therapeutics 4.2 (2021): 187-199.
  21. Wang Y., et al. “Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial”. Lancet 395 (2020): 1569-1578.
  22. Spinner CD., et al. “Effect of remdesivir vs standard care on clinical status at 11 days in patients with moderate COVID-19: a randomized clinical trial”. JAMA 324 (2020): 1048-1057.

Citation

Citation: Mamun Al Mahtab., et al. “Clinical Outcome of Using Remdesivir in Bangladeshi Hospitalized Patients with Severe Coronavirus Disease (COVID-19)”.Acta Scientific Medical Sciences 5.9 (2021): 18-24.

Copyright

Copyright: © 2021 Mamun Al Mahtab., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.111

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