The antiviral medicine remdesivir gained publicity when the president took it to treat his case of COVID-19, but the drug isn’t exclusive to the highest office in the country. In fact, Carroll Hospital reports that about half of those hospitalized for the disease there have taken remdesivir to treat their symptoms.
Carroll Hospital administered its first dose of remdesivir, brand name Veklury, in mid-May, according to Dr. Mark Olszyk, chief medical officer. At least 62 patients have taken it since, Olszyk said Monday. Between May 15 and Oct. 19, Carroll Hospital had 121 patients who were COVID-19 positive and hospitalized, according to spokesperson Simone Lindsay.
The U.S. Food and Drug Administration granted emergency use of remdesivir in the spring and on Thursday approved it as the first drug to treat COVID-19. The drug reduced recovery time from 15 to 10 days on average, a large study led by the U.S. National Institutes of Health found, according to The Associated Press.
The average person probably never heard of remdesivir before the coronavirus pandemic, Olszyk said, but it was originally made as a possible treatment for hepatitis C and was tested against other RNA viruses, including Ebola and earlier forms of SARS (severe acute respiratory syndrome), the latter of which COVID-19 is a variety, according to Olszyk.
Earlier this month, President Donald Trump spent three days at Walter Reed National Military Medical Center in Bethesda being treated for COVID-19. There, he was given remdesivir, as well as steroids and an experimental antibody treatment from Regeneron Pharmaceuticals Inc., The Associated Press reported.
Once it’s injected, remdesivir is designed to be converted by the body into a different chemical that disrupts the replication of COVID-19, the disease caused by the novel coronavirus, Olszyk said. It is administered through a vein and is typically given in doses over five days.
“Imagine that the RNA virus is trying to reproduce itself. And so it’s making lots and lots of photocopies, and this basically introduces a scrap of last Sunday’s newspaper into the photocopier,” he said. It’s like reading furniture assembly instructions and suddenly finding Sunday comics where the next step should be, he added — without those instructions, the virus can’t replicate.
When remdesivir became available in the spring, LifeBridge Health (of which Carroll Hospital is a part) developed criteria for patients to receive the medicine in accordance with FDA recommendations, Olszyk said. This typically applies to those with more serious cases, he said.
A Carroll Hospital patient is eligible if they test positive and their oxygen saturation while breathing room air drops below 94%, or if they test positive and need supplemental oxygen or a ventilator, according to Olszyk. Normal oxygen levels are 100% or close to it, he said.
A patient must also not have any liver or kidney issues, he said, because a side effect of remdesivir is raising blood levels of liver enzymes, higher levels of which can indicate injury or damage to the liver. Other side effects include nausea, sweating and low blood pressure. Side effects are presented to patients in a fact sheet prior to them deciding whether they’d like to take remdesivir, Olszyk said. He wasn’t aware of any reported side effects among Carroll Hospital patients.
About 70 different ingredients comprise the medicine, which requires 25 steps and six to nine months to manufacture, Olszyk said. Remdesivir, which was created by Gilead Sciences Inc., is approved for people at least 12 years old and weighing at least 88 pounds (40 kilograms) who need hospitalization for their coronavirus infection, according to The Associated Press.
“It’s not something you could cook up in your garage, by any means," he said.
And the treatment can be expensive. The New York Times has reported that it costs $3,120 when purchased by private insurers and $2,340 through public programs, such as Medicare and Medicaid. Olszyk couldn’t speak to how much remdesivir could cost a Carroll Hospital patient, as insurance policies vary.
Thus far, it appears remdesivir can reduce the severity of symptoms, but hasn’t proven to be a life-saving treatment, Olszyk said.
A recent study sponsored by the World Health Organization examined more than 11,000 people across 30 countries and found that remdesivir did not definitively reduce COVID-19 deaths. An earlier study led by the U.S. National Institutes of Health determined the drug shortened patients’ recovery time by an average of five days.
In June, Gilead Sciences announced that the results of a trial showed patients in a five-day remdesivir treatment group were 65% more likely to improve clinically within 11 days, compared to those who received standard care. A 10-day treatment group also saw improvement, according to Gilead Sciences.
Olszyk acknowledged remdesivir’s use in COVID-19 cases is fairly new. He said health care professionals will continue to learn more about its effectiveness.