“Discussion: Of this case series of five COVID-19 patients requiring ICU treatment for respiratory distress and treated with remdesivir, three (patients 1, 3, and 4) had a favourable outcome despite the initial respiratory severity. They were weaned off oxygen between day 14 and day 19 of illness and were discharged between day 20 and day 26 of illness. Patients 2 and 5 died in the ICU on day 25 and day 31 of illness with multi-organ failure …
As described in previous case reports (Grein et al., 2020, Kujawski et al., 2020), four of the five patients experienced major side effects while on remdesivir treatment: two suffered acute renal injury and two had a maculopapular rash with cytolytic hepatitis. Both kidney failure events could have been related either to remdesivir or to the SARS-CoV-2 infection… A recent randomized controlled study (Wang et al., 2020b) did not show any clinical of benefit for remdesivir treatment, but probably lacked power. Of note, 12% of patients in the remdesivir group discontinued remdesivir due to adverse events (compared with 5% in the placebo group).
In conclusion, the cases of the five patients presented herein highlight some difficulties with remdesivir infusion when administered in most patients with advanced disease. Particular attention should be paid to hepatic and kidney function when administering this treatment.”
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