The aim of this report is to review the literature and shed light on the uncertainties surrounding the use of antiviral agents in general and remdesivir in COVID-19 patients. This review evaluated a battery of antiviral compounds and their effectiveness in the treatment of COVID-19 since the beginning of the pandemic. Remdesivir is the only antiviral approved by the EMA and FDA for the treatment of SARS-CoV-2 infection. This work extensively reviews remdesivir data generated from clinical trials and observational studies, paying attention to the most recent data, and focusing on outcomes to give readers a more comprehensive understanding of the results. This review also discusses the recommendations issued by official bodies during the pandemic in the light of the current knowledge. The use of remdesivir in the treatment of SARS-CoV-2 infection is justified because a virus is the causative agent that triggers the inflammatory responses and its consequences. More trials are needed to improve the management of this disease.
It was concluded that the use of remdesivir, when indicated, would shorten hospital stays and reduce the risk of progression to the intensive care unit, and therefore represents a saving in staff hours and other resources. Remdesivir acts by inhibiting the activity of RNA polymerase, a protein that is more conserved in different SARS-Cov-2 variants than the spike protein the target of vaccines, and remdesivir has also shown inhibitory activity against variants.
Remdesivir is marketed as intravenous agent formulated by sulfobutyl beta.cyclodextrin (SBECD, Captisol, Dexolve) under the trade name Veklury (Gilead Sciences).
Moreno S, Alcázar B , Dueñas C, González del Castillo J, Olalla J, Antela A Use of Antivirals in SARS-CoV-2 Infection. Critical Review of the Role of Remdesivir. Drug Design, Development and Therapy 2022, 16, 827—841. DOI:https://doi.org/10.2147/DDDT.S356951