Doctors don’t want to write off remdesivir yet

Despite WHO advice against drug, doctors say it has helped in some cases

Despite the World Health Organisation (WHO) advising against the use of antiviral drug Remdesivir for Covid patients, city doctors vouch for the drug’s effectiveness.

A city doctor gave an example. His 65-year-old female patient with diabetes, hypertension, coronary artery disease had fever and cough. Three days after being admitted to hospital, her cough and breathing difficulty worsened, her oxygen level dropped and she needed oxygen support. She was started on moderate protocol and was initiated on injection Remdesivir, steroids and blood thinners. After five days of therapy, her oxygen level gradually improved and over the next 3-4 days normalised. She is now in home isolation. Follow-up visits show she has completely recovered with no residual lung issues.

This is just one example though doctors conceded that Remdesivir may not work in all cases. Dr Aravinda GM (Consultant – Internal Medicine, Manipal Hospitals, Jayanagar) said Remdesivir helps covid patients, particularly in early hypoxia. “We have seen in the last four to six months that Remdesivir is the only antiviral drug that showed some benefit for covid patients. In our practice, out of 350 patients, this drug has been used by close to 200 of various age groups (20 years and above). We have also recommended the drug to patients with co-morbidities and they had a positive outcome.”

Dr. Pavan Yadav (Consultant, Interventional Pulmonology, Aster RV Hospital) said patients given Remdesivir have shown significant improvement.

We have seen in the last four to six months that Remdesivir is the only antiviral drug that showed some benefit for covid patients ­

–Dr Aravinda GM, Manipal Hospitals

“We also give blood thinners and steroid injections to the patients and the combination has shown good results. Amongst people who don’t respond to this, we consider Tocilizumab and Plasma therapy,” he said.

However, Dr. Pradeep Rangappa (Senior Consultant – Critical Care, Columbia Asia Referral Hospital Yeshwanthpur) said it was the Solidarity trial of Remdesivir done across 30 countries that raised questions over Remdesivir.

“The trial has a few shortcomings like it does not detail timing of initiation of this drug as early administration of this drug has shown benefit in preventing progression of covid in previous two trials. The study as it’s published shows median time of randomisation as nine days after the symptom onset which possibly could be late administration not leading to the expected benefit,” he added.

Dr Ravindra M Mehta, (Senior Consultant and HOD – Pulmonology & Interventional pulmonology, Apollo Speciality Hospitals) echoed these views on the study. “There are many issues with the solidarity trial; which includes the fact that this study was done at the early stages of the pandemic, where many drugs were used and we are not sure of the role of each. Until we get more data on categorical data, our current practice, which even most parts of the world are still concurring with, will continue to use Remdesivir for the right category of patients.

However, it is not to be abused for patients who have a mild case of covid,” he said.

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