In a recent study published by the New England Journal of Medicine, investigators  studied the compassionate use of remdesivir to treat patients with severe COVID-19 complications. Participants consisted of patients who had tested positive for the virus and had oxygen saturation levels of 94 or less while they were breathing ambient air or were on oxygen support. Patients received a 10-day trial of the drug, in which 200mg were administered intravenously on the first day and 100mg were administered daily for the remaining nine days. The investigators concluded that remdesivir led to clinical improvement in 36/53 patients.


Smith College

In addition to the milder situation treatments, it often requires hospitalization and advanced ventilatory support.

Treatment of Severe COVID-19

Grein, J., Ohmagari, N., Shin, D., Diaz, G., Asperges, E., Castagna, A., ... & Nicastri, E. (2020). Compassionate use of remdesivir for patients with severe Covid-19. New England Journal of Medicine, 382(24), 2327-2336. DOI: 10.1056/NEJMoa2007016 https://www.nejm.org/doi/full/10.1056/NEJMoa2007016

Compassionate Use of Remdesivir for Patients with Severe COVID-19

Compassionate use of Remdesivir to Treat Patients with Severe COVID-19

A study published in the Journal of Allergy and Clinical Immunology aimed to assess the efficacy and safety of using ruxolitinib, a Janus-associated kinase inhibitor, in treating patients with severe COVID-19.  Patients aged 18 years and up diagnosed with severe COVID-19 based on Chinese management guidelines were recruited for this study.  The study participants were randomly placed into two groups: a group treated with ruxolitinib and standard COVID-19 care and a group with a placebo treatment of vitamin C and standard care.  It was determined that although ruxolitinib treatment did not result in significantly quicker clinical improvement, the ruxolitinib recipients exhibited a numerically accelerated clinical improvement, meaning that more patients who received ruxolitinib demonstrated a quicker recovery from lymphopenia and tomography improvement than the number of patients in the placebo group.  No safety concerns resulted from ruxolitinib use.   

Ruxolitinib Use in Treatment of Severe COVID-19

The cytokine storm that characterizes COVID-19 may be able to be reduced with the monoclonal antibody, tocilizumab, that targets the IL-6 (Interleukin-6) pathway. 20 Patients were given tocilizumab in addition to normal routine treatment over a period of nine days during the month of February 2020 in two different hospitals located in China.  
Results: 
- fever returned to normal within the first day
- After 5 days of treatment with tocilizumab, 75% of the patients experienced improved oxygen intake on their own, and 1 patient no longer needed oxygen therapy. 
- The percentage of lymphocytes in peripheral blood, (the blood that travels through the heart, arteries, capillaries and veins) was abnormal in 85% of patients before treatment with tocilizumab, but returned to normal in 52.6% of patients within 5 days of treatment with tocilizumab. 
- C-reactive protein significantly decreased in 84.2% of patients after 5 days, signifying reduced inflammation. 
- All 20 patients were discharged after 15 days of taking tocilizumab. 
- The preliminary data demonstrates that tocilizumab could be an effective treatment for patients with severe cover-19. 


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