{"pk":13750,"title":"Remdesivir for the Treatment of COVID-19:  A Systematic Review of the Literature","subtitle":null,"abstract":"In March 2020, the World Health Organization declared the spread of SARS-CoV-2 a global pandemic. To date, coronavirus disease-2019 (COVID-19) has spread to over 200 countries, leading to over 1.6 million cases and over 99,000 deaths. Given that there is neither a vaccine nor proven treatment for COVID-19, there is currently an urgent need for effective pharmacotherapy. To address the need for an effective treatment of SARS-CoV-2 during the worldwide pandemic, this systematic review of intravenous (IV) remdesivir was performed. Remdesivir, an anti-viral prodrug originally developed to treat Ebola virus disease, has shown broad spectrum activity against the Coronavirus family. A recent case report reported improvement of clinical symptoms with remdesivir in a patient with COVID-19. After conducting a systematic search of 18 clinical trial registries and three large scientific databases, we identified 86 potentially eligible items. Following removal of duplicates (n = 21), eligible studies were reviewed independently by two authors. After the first round of screening, inter-rater agreement was 98.5% (κ = 0.925). After the second round of full-text screening, inter-rater agreement was 100%. A total of seven ongoing and recruiting clinical trials of remdesivir (100-200 milligrams, intravenous [IV]) were included. We identified the following primary outcomes: patients discharged (n = 2); time to clinical status improvement (n = 2); improved O2 saturation (n = 2); body temperature normalization (n = 2); and clinical status (n = 1). Secondary outcomes in all identified studies included documentation of adverse events. Phase 3 trials are expected to be completed between April 2020–2023. Therefore, despite supportive data from in vitro and in vivo studies, the clinical effectiveness of IV remdesivir for treatment of COVID-19 and potential side effects remain incompletely defined in the human population.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"remdesivir"},{"word":"GS-5734"},{"word":"COVID-19"},{"word":"SARS-CoV-2"},{"word":"2019-nCoV"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9z6961f2","frozenauthors":[{"first_name":"Arif","middle_name":"","last_name":"Musa","name_suffix":"","institution":"Wayne State University School of Medicine, Detroit, Michigan\nMusa Biomedical Consulting, Anaheim, California","department":"None"},{"first_name":"Kasim","middle_name":"","last_name":"Pendi","name_suffix":"","institution":"Southern California University of Health Sciences, School of Professional Studies, Whittier, California","department":"None"},{"first_name":"Areio","middle_name":"","last_name":"Hashemi","name_suffix":"","institution":"William Carey University, College of Osteopathic Medicine,  Hattiesburg, Mississippi","department":"None"},{"first_name":"Elizabeth","middle_name":"","last_name":"Warbasse","name_suffix":"","institution":"Wayne State University School of Medicine, Detroit, Michigan","department":"None"},{"first_name":"Sarkis","middle_name":"","last_name":"Kouyoumjian","name_suffix":"","institution":"Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, Michigan","department":"None"},{"first_name":"Jenna","middle_name":"","last_name":"Yousif","name_suffix":"","institution":"Wayne State University School of Medicine, Detroit, Michigan","department":"None"},{"first_name":"Emily","middle_name":"","last_name":"Blodget","name_suffix":"","institution":"University of Southern California Keck School of Medicine, Division of Infectious Diseases, Department of Medicine, Los Angeles, California","department":"None"},{"first_name":"Susan","middle_name":"","last_name":"Stevens","name_suffix":"","institution":"Wayne State University School of Medicine, Detroit, Michigan","department":"None"},{"first_name":"Besma","middle_name":"","last_name":"Aly","name_suffix":"","institution":"Wayne State University School of Medicine, Detroit, Michigan","department":"None"},{"first_name":"David","middle_name":"A.","last_name":"Baron","name_suffix":"","institution":"Western University of Health Sciences, Office of the Provost, Pomona, California","department":"None"}],"date_submitted":"2020-04-12T01:41:52+01:00","date_accepted":"2020-04-12T01:41:52+01:00","date_published":"2020-05-20T21:29:26+01:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/13750/galley/7170/download/"}]}