The effects of remdesivir on long-term symptoms in patients hospitalised for COVID-19: a pre-specified exploratory analysis

Abstract

There is an unmet need for treatment of long-term symptoms following COVID-19. Remdesivir is currently the only antiviral approved by the European Medicines Agency for hospitalised patients. Here, we report on the effect of remdesivir in addition to standard of care on long-term symptoms and quality of life in hospitalised patients with COVID-19 as part of the open-label randomised NOR-Solidarity trial (NCT04321616). A total of 185 patients were included in the main trial, of which 118 (60%) were randomised to either remdesivir (n = 42; 36%) or a post-hoc defined control group composed of patients who received standard of care alone or standard of care with hydroxychloroquine (n = 76; 64%). Participants were given quality of life surveys to fill out to gauge their self-reported health over time (the COPD assessment test, the EQ-5D-5L and the RAND SF-36). Here we show that after three months, patients treated with remdesivir do not show significant improvements in stated health compared to those who were not. There are self-reported symptoms of fatigue [mean remdesivir group 2.6 (standard deviation 1.5) v control 2.1 (1.6), 95% confidence interval(CI) −1.17 to 0.15, p = 0.129], shortness of breath [3.0 (1.7) v 2.1 (1.8), 95% CI −1.53 to 0.16, p = 0.110] and coughing [1.8 (1.6) v 1.2 (1.5), 95% CI −1.3 to 0.33, p = 0.237] 3 months after randomisation assessed via the COPD Assessment Test. Our findings indicate that treatment with remdesivir during hospitalisation does not provide any clinically relevant long-term benefit. Remdesivir is a medicine that is used to treat people with COVID-19. It has been found to help people get better faster, but we did not know whether it also relieved them of long-term symptoms such as persistent coughing, fatigue, or shortness of breath. To research this, we randomly assigned hospitalised patients with COVID-19 to either remdesivir on top of their normal care, or only normal care, with or without hydroxychloroquine (a drug later found to have no effect on COVID-19). We then compared participant’s symptoms after 3 months. Our results show that there is probably no benefit of using remdesivir during hospitalisation for long-term symptom relief. Patrick-Brown et al report the findings of a secondary study adjunct to the Nor-Solidarity trial that evaluated remdesivir versus standard of care for the treatment of COVID-19. While remdesivir appears to be safe for use in these patients, there does not appear to be any long-term clinical benefit to its use in terms of long-COVID symptoms.