Early Remdesivir Data for Covid-19 Is Finally Here

In late January and early February, as the novel coronavirus that causes Covid-19 began to spread outside of China , Andre Kalil was spending more and more time inside his office at the University of Nebraska Medical Center in Omaha on the phone and emailing with researchers at the National Institutes of Health. With no known treatments or vaccines against the deadly respiratory virus, the NIH was keen to launch a clinical trial of the most promising candidates, starting with remdesivir, a medicine developed by US-based drugmaker Gilead to treat Ebola . They wanted Kalil to lead that trial.
An infectious disease physician, he was a natural choice for two reasons. One, he’d worked on an unusual trial of Ebola treatments during the 2014-15 West African outbreak that created a new model for evaluating experimental drugs during a public health crisis. And two, he had access to UNMC’s Biocontainment Unit, the largest of 10 nationally-designated centers for treating people with the world’s most infectious deadly diseases. Though the US only had a handful of Covid-19 patients at that time, sooner or later there would be more, and Kalil knew they’d probably wind up in Omaha. “We’re one of the few centers in the country that can receive US patients from other countries during an outbreak, so we viewed it as just a matter of time,” he told WIRED in a recent interview.
person lathering hands with soap and water

How Long Does the Coronavirus Live on Surfaces?

Plus: What it means to “flatten the curve,” and everything else you need to know about the coronavirus.

Sure enough, on February 17, 13 Americans arrived jet-lagged, exhausted, and sick or suspected of having Covid-19 . They had just endured a 10-hour evacuation flight from Japan on a chartered cargo jet, and before that, more than two weeks of floating quarantine aboard the doomed Diamond Princess cruise ship.Just over a week later, three of those cruise ship patients signed up to be the first participants in the federal government’s clinical trial, the first in the US to evaluate experimental Covid-19 treatments. For ten days, they received a two-hour daily intravenous infusion of a clear liquid that contained either remdesivir—a molecule that impersonates the virus’s genetic building blocks, disrupting its ability to replicate —or a placebo of sterile saltwater solution. They didn't know which one they were getting. Their doctors didn’t know either. But UNMC researchers would carefully collect measurements of how each patient fared. Later, as the disease continued to spread, they would add that information to similar data that would eventually be gathered from more than a thousand other Covid-19 patients at more than 68 hospitals in the US and 21 other countries in Europe and Asia.
This week, the NIH offered the first peek at results from the closely-watched study. In a statement released Wednesday, the National Institute of Allergy and Infectious Diseases—the NIH branch that is conducting the trial—said preliminary data shows remdesivir speeds up the recovery of some Covid-19 patients. “Specifically, the median time to recovery was 11 days for patients treated with remdesivir compared with 15 days for those who received placebo,” according to the statement.The finding, though modest, would represent the first treatment shown to improve outcomes in patients infected with the coronavirus, which as of Thursday had sickened 3.2 million people worldwide. At least 1 million of those are in the US alone, where the official death toll has reached more than 60,000. However, it’s difficult to evaluate the results without full, detailed data about the patients, how sick they were, and any potential side effects, which the NIAID has not yet provided. That information is expected to be released within days, according to NIAID director Anthony Fauci, who revealed the study’s results during a meeting with reporters at the White House Wednesday afternoon.