The anti-viral drug
remdesivir outsmarts the coronavirus.
Posing as the one of the building blocks the virus needs to make copies
of itself, it’s incorporated into the virus’s genome —
stopping it from reproducing and essentially shutting it down in its tracks,
research has found.
Developed by the Bay Area’s Gilead Sciences in 2014 to fight Ebola
— which it didn’t do very well — remdesivir has been
pressed into service to battle the SARS and MERS coronaviruses effectively.
And now, trials involving thousands of patients at hospitals across the
nation suggest it may be a potent treatment for COVID-19 as well.
A dozen hospitals across Southern California have enrolled — and
are recruiting — patients for the
trials, including Kaiser Permanente medical centers in Anaheim, Downey, Fontana,
Harbor City, Los Angeles, Moreno Valley, Ontario and Panorama City; Mission
Hospital Regional Medical Center; Hoag Memorial Hospital Presbyterian
in Newport Beach; St. Joseph Hospital of Orange; and Providence St. John’s
Health Center in Santa Monica.
Results are expected to start rolling out next month, but early data leaked
from the University of Chicago have researchers and investors abuzz.
Extremely sick people treated with the drug in Chicago showed rapid recovery
in fever and respiratory symptoms, with nearly all patients discharged
in less than a week, according to
a report in STAT.
Southern Californians appear to be responding positively, too.
“The majority of patients have done very well,” said Deborah
Fridman, director of clinical research at Hoag Hospital, which has enrolled
28 patients in the trial for severe illness and eight in the trial for
moderate illness.
Researchers are not allowed to release data yet, and try to temper high
expectations with caution.
“Hundreds of Kaiser Permanente patients have received remdesivir
as a part of these studies,” said a spokesperson for the health
care giant in California.
“While early results are promising, Gilead has said, ‘What
we can say at this stage is that we look forward to data from ongoing
studies becoming available.’ “
At St. Joseph, the research team plans to follow up with patients about
a month after their trial began to track recovery.
Gilead’s stock has soared some 30 percent in recent weeks as excitement
over remdesivir builds. But that’s tempered as investors ponder
the long-term usefulness of a treatment, when so many vaccines are in
development to prevent people from getting sick in the first place, according
to MarketWatch.
Promising science
But for those who get very sick now, with vaccines still a year or so away,
an effective treatment could mean the difference between life and death.
In the New England Journal of Medicine on April 10, Gilead announced results
from a cohort analysis of 53 patients hospitalized with severe complications
of COVID-19 who were treated with remdesivir on what’s known as
“an individual compassionate use basis.” That’s outside
the scope of the national studies currently being conducted.
The majority of those patients showed clinical improvement, and no new
safety signals were identified with remdesivir treatment, the analysis found.
Nearly two thirds of the patients were on mechanical ventilation, and remdesivir
improved oxygen levels in 68 percent of them — 36 of the 53. Nearly
half of all patients were discharged from the hospital following treatment.
Clinical improvement was less frequent among patients on invasive ventilation,
and among patients at least 70 years old.
“Currently there is no proven treatment for COVID-19. We cannot draw
definitive conclusions from these data, but the observations from this
group of hospitalized patients who received remdesivir are hopeful,”
said Jonathan D. Grein of Cedars-Sinai Medical Center in Los Angeles,
lead author of the journal article, in a statement. “We look forward
to the results of controlled clinical trials to potentially validate these
findings.”
In the meantime, a small study of rhesus macaques led by the National Institute
of Allergy and Infectious Diseases offers more reason for optimism.
The NIAID, with Gilead, looked at 12 animals infected with COVID-19. Half
were treated with intravenous remdesivir; the other half were not.
Animals treated with remdesivir didn’t show signs of respiratory
disease and had reduced fluids in the lungs, the study found. Viral loads
were significantly reduced as soon as 12 hours after the first treatment,
and there was a clear reduction in damage to lung tissue, it found.
“Therapeutic remdesivir treatment initiated early during infection
has a clear clinical benefit in SARS-CoV-2-infected rhesus macaques,”
the study concluded. “These data support early remdesivir treatment
initiation in COVID-19 patients to prevent progression to severe pneumonia.”
While remdesivir helped prevent pneumonia, it did not reduce virus shedding
by the animals. “This finding is of great significance for patient
management, where a clinical improvement should not be interpreted as
a lack of infectiousness,” the researchers said.
Of course, people are not rhesus macaques. But researchers from the University
of Alberta examined how remdesivir works, and concluded it’s highly
effective in stopping the replication mechanism of the coronavirus that
causes COVID-19, according to research published in the Journal of Biological
Chemistry.
Most everyone will get COVID
Officials caution that, even with hope in the air for a treatment or vaccine,
people must not get sloppy.
“We’re seeing fewer patients in the past week, probably because
California started social distancing before other states,” said
Fridman of Hoag Hospital. “The only reason we’re doing as
well as we are is that people have adhered to the social distancing guidelines.They’re
keeping themselves protected and protecting others.
“We’re going to have to continue with that,” Fridman
said. “We don’t want to have a mass amount of people getting
sick at the same time.”
Most people don’t realize that probably everybody will get COVID,
sooner or later, she said.
Preliminary results of antibody testing by USC and Los Angeles County suggest
that the number of people who’ve been infected with the virus is
about 40 times larger than the number of confirmed cases.
About 4.1 percent of Los Angeles County adults have been infected with
the virus, said Barbara Ferrer, director of public health for the county
— which means that some 95 percent of people remain vulnerable.
To view the original Orange County Register article, please click
here.