# So what should I know about remdesivir? **URL:** \ **Category:** Great Debates\ **Created:** [April 17, 2020, 3:19pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984 "2020-04-17T15:19:55Z")\ **Posts on this page:** 14\ **Page:** 1
**Author:** ![Do\_Not\_Taunt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/do_not_taunt/32/2968_2.png) [@Do\_Not\_Taunt](https://boards.straightdope.com/u/Do_Not_Taunt)\ **Post date:** [April 17, 2020, 3:19pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/1 "2020-04-17T15:19:55Z")
I’m assuming there may be some debate aspects to this, so trying in GD… There’s a [lively debate](https://boards.straightdope.com/sdmb/showthread.php?t=893520) over in P&E about hydroxychloroquine, which the President has been pitching lately. But the news about a different treatment drug, [remdesivir](https://www.cnn.com/2020/04/16/health/coronavirus-remdesivir-trial/index.html), seems to be potentially more positive. Remdesivir, unlike hydroxychloroquine, is actually an antiviral. Clinical trials in Chicago have seemed positive, so far. But what the hell do I know? What do the local experts - MDs and epidemiologists - think about this? Might remdesivir be our magic bullet to treat COVID-19? Why or why not? > [@CNN](#): > > Covid-19 patients who are getting an experimental drug called remdesivir have been recovering quickly, with most going home in days, STAT News reported Thursday after it obtained a video of a conversation about the trial. > > The patients taking part in a clinical trial of the drug have all had severe respiratory symptoms and fever, but were able to leave the hospital after less than a week of treatment, STAT quoted the doctor leading the trial as saying. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [April 17, 2020, 3:37pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/2 "2020-04-17T15:37:17Z")
It depends. If we’re talking about people in the hospital with the virus then the usual protocols don’t apply in an emergency. If doctors think it’s useful then have a go at it. Hospitals have all the tools available to deal with any side affects. ---
**Author:** ![Do\_Not\_Taunt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/do_not_taunt/32/2968_2.png) [@Do\_Not\_Taunt](https://boards.straightdope.com/u/Do_Not_Taunt)\ **Post date:** [April 17, 2020, 4:05pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/3 "2020-04-17T16:05:52Z")
Well, that’s what’s happening now. Trump had pushed through an order to enable doctors to use Remdesivir under compassionate use, but Gilead has very limited supply currently, so they’re reserving it all for these clinical trials. But my question isn’t that, but how likely is it that Remdesivir actually does work against COVID-19 (unlike hydroxychloroquine, which seems to not actually do anything), how strong is the effect, how severe are the side effects? In other words, will this be a magic bullet against COVID-19 the way that, say, penicillin is (or was, at least, at first) against staph infections? ---
**Author:** ![PastTense](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pasttense/32/14550_2.png) [@PastTense](https://boards.straightdope.com/u/PastTense)\ **Post date:** [April 17, 2020, 4:57pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/4 "2020-04-17T16:57:35Z")
Assuming it turns out to be successful it wouldn’t surprise me if the price turns out to be more than most people earn in a year. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [April 17, 2020, 5:25pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/5 "2020-04-17T17:25:23Z")
> [@Do\_Not\_Taunt](#): > > Well, that’s what’s happening now. Trump had pushed through an order to enable doctors to use Remdesivir under compassionate use, but Gilead has very limited supply currently, so they’re reserving it all for these clinical trials. > > But my question isn’t that, but how likely is it that Remdesivir actually does work against COVID-19 (unlike hydroxychloroquine, which seems to not actually do anything), how strong is the effect, how severe are the side effects? In other words, will this be a magic bullet against COVID-19 the way that, say, penicillin is (or was, at least, at first) against staph infections? Penicillin works against bacteria (which is what staff is). Viruses are different. We have never cured a virus. Fighting a virus involves reducing the effects after-the-fact or training the the immune system to recognize it before it hits. I hope Remdesivir is one of the drugs that helps and more follow. ---
**Author:** ![Do\_Not\_Taunt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/do_not_taunt/32/2968_2.png) [@Do\_Not\_Taunt](https://boards.straightdope.com/u/Do_Not_Taunt)\ **Post date:** [April 17, 2020, 5:34pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/6 "2020-04-17T17:34:08Z")
> [@Magiver](#): > > Penicillin works against bacteria (which is what staff is). Viruses are different. We have never cured a virus. Fighting a virus involves reducing the effects after-the-fact or training the the immune system to recognize it before it hits. > > I hope Remdesivir is one of the drugs that helps and more follow. I’m familiar with the differences between viruses and bacteria. And I don’t think it’s really true that we have never cured a virus - the virus that causes Hepatitis C is frequently (though expensively) cured with antivirals these days. But even if the effect of remdesivir is not to ‘cure’ covid, but merely to suppress the infection long enough for your own immune system to rid your body of it, that seems good enough to me. ---
**Author:** ![Babale](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/babale/32/15666_2.png) [@Babale](https://boards.straightdope.com/u/Babale)\ **Post date:** [April 17, 2020, 5:36pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/7 "2020-04-17T17:36:36Z")
It is pretty much known that there will not be a silver bullet treatment that stops an active case of CORVID-19. I cant think of any virus we have a treatment like that for. Thing is, penicillin kills staph. We dont have a treatment that kills any virus in a comparable way. What we can do is make the body a hostile environment for virus replication. We do that by changing some of its properties, like temperature (a fever). But that is less effective and has more side effects than killing a bacteria does. We can directly target the virus in some ways too, such as by disrupting its ability to manipulate and replicate DNA. But again, not as effective as killing a bacteria is. ---
**Author:** ![Hermitian](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hermitian/32/470_2.png) [@Hermitian](https://boards.straightdope.com/u/Hermitian)\ **Post date:** [April 17, 2020, 5:39pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/8 "2020-04-17T17:39:08Z")
What a terrible hard to pronounce name for a drug. ---
**Author:** ![Do\_Not\_Taunt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/do_not_taunt/32/2968_2.png) [@Do\_Not\_Taunt](https://boards.straightdope.com/u/Do_Not_Taunt)\ **Post date:** [April 17, 2020, 5:44pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/9 "2020-04-17T17:44:26Z")
> [@Babale](#): > > It is pretty much known that there will not be a silver bullet treatment that stops an active case of CORVID-19. I cant think of any virus we have a treatment like that for. Thing is, penicillin kills staph. We dont have a treatment that kills any virus in a comparable way. > > What we can do is make the body a hostile environment for virus replication. We do that by changing some of its properties, like temperature (a fever). But that is less effective and has more side effects than killing a bacteria does. > > We can directly target the virus in some ways too, such as by disrupting its ability to manipulate and replicate DNA. But again, not as effective as killing a bacteria is. Again, I would point to the virus that causes Hepatitis C as a counter-example. I’m in no way an expert, so maybe those antivirals are more akin to disrupting the ability of the virus to manipulate and replicate DNA. However, given the very high cure rate, that’s not a difference that’s going to be meaningful to non-experts. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [April 17, 2020, 7:04pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/10 "2020-04-17T19:04:47Z")
> [@Do\_Not\_Taunt](#): > > I’m familiar with the differences between viruses and bacteria. And I don’t think it’s really true that we have never cured a virus - the virus that causes Hepatitis C is frequently (though expensively) cured with antivirals these days. But even if the effect of remdesivir is not to ‘cure’ covid, but merely to suppress the infection long enough for your own immune system to rid your body of it, that seems good enough to me. No arguments here or to what I said. Given the worldwide scope of it I would expect a good drug regiment to develop out of sheer force of will. There’s probably a dozen drugs being tried that we haven’t heard about because politicians haven’t mentioned it yet. ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [April 17, 2020, 7:20pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/11 "2020-04-17T19:20:31Z")
I haven’t actually researched Remdesivir itself but I read that it was the “most promising” option and did research on how it works and searched to see if there was anything OTC that was related to the basic mechanism. Remdesivir is an [Adenosine](https://en.wikipedia.org/wiki/Adenosine) [analogue](https://en.wikipedia.org/wiki/Nucleic_acid_analogue). This is a class of drugs that stop viruses from mucking with DNA and thus stops them from being able to replicate. Adenosine also seems to [modulate how the immune system works](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3619132/). This is important for Covid-19 since one of the largest causes of death seems to be attributable to [Cytokine Storm](https://en.wikipedia.org/wiki/Cytokine_release_syndrome). Having its hand in at least two baskets makes it a pretty good option. It slows the disease and prevents the body from destroying itself trying to fight it. As said, I was looking for an OTC option since remdesivir is going to be rationed to those in hospital, and I’d personally prefer to not end up in hospital nor have anyone I know end up in hospital. As such, I looked to see if there are any adenosine analogues in nature that have been approved as a supplement. The only option which I was able to identify is a species of mushroom, the cordyceps. Cordyceps were investigated for use against SARS (another Coronavirus) and, in rats, shown to be effective: > **[Protective roles of Cordyceps on lung fibrosis in cellular and rat models -...](https://pubmed.ncbi.nlm.nih.gov/22796203/)** > > The findings provide an insight into the preventive and therapeutic potentials of Cordyceps for the treatment of lung fibrosis. Not so effective as a proper medicine but better than a placebo (and I don’t believe that cordycepin - the active ingredient - was isolated for the test). It has been tested for possible effectiveness against cytokine storm: > **[Regulation of human cytokines by Cordyceps militaris - PubMed](https://pubmed.ncbi.nlm.nih.gov/28911461/)** > > Cordyceps (Cordyceps militaris) exhibits many biological activities including antioxidant, inhibition of inflammation, cancer prevention, hypoglycemic, and antiaging properties, etc. However, a majority of studies involving C. militaris have focused... And it has demonstrated some effectiveness as an antiviral: [https://www.researchgate.net/publication/283302854\_Journal\_of\_Virology\_Antiviral\_Research\_Cordycepin\_an\_Adenosine\_Analogue\_Executes\_Anti\_Rotaviral\_Effect\_by\_Stimulating\_Induction\_of\_Type\_I\_Interferon](https://www.researchgate.net/publication/283302854_Journal_of_Virology_Antiviral_Research_Cordycepin_an_Adenosine_Analogue_Executes_Anti_Rotaviral_Effect_by_Stimulating_Induction_of_Type_I_Interferon) None of it means that anything will work at a sufficient level to be useful, or even work at all in real humans in the real world, nor be safe. But it does seem promising and the baby brother is, at least, safe enough to use OTC. ---
**Author:** ![Chisquirrel](https://avatars.discourse-cdn.com/v4/letter/c/6bbea6/32.png) [@Chisquirrel](https://boards.straightdope.com/u/Chisquirrel)\ **Post date:** [April 17, 2020, 7:41pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/12 "2020-04-17T19:41:32Z")
> [@Magiver](#): > > No arguments here or to what I said. Given the worldwide scope of it I would expect a good drug regiment to develop out of sheer force of will. > > There’s probably a dozen drugs being tried that we haven’t heard about because politicians haven’t mentioned it yet. Oh, way more than a dozen. [The NIH is tracking over 600 studies of COVID-19 treatment.](https://clinicaltrials.gov/ct2/results?cond=covid-19&term=&cntry=&state=&city=&dist=&Search=Search) Remdesivir and Favipiravir are two promising antivirals in study at the moment, but they’re trying just about everything out there, it seems. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [April 18, 2020, 8:00pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/13 "2020-04-18T20:00:59Z")
> [@Chisquirrel](#): > > Oh, way more than a dozen. [The NIH is tracking over 600 studies of COVID-19 treatment.](https://clinicaltrials.gov/ct2/results?cond=covid-19&term=&cntry=&state=&city=&dist=&Search=Search) Remdesivir and Favipiravir are two promising antivirals in study at the moment, but they’re trying just about everything out there, it seems. That’s a great link and I thank you for it. But that isn’t just about drugs being tested. It’s about everything medical as it applies to the pandemic. And YAY. We now have the power of supercomputers to sift through data. When the dust settles it will be exciting to see how fast things moved once the world put it’s shoulder into it. We already have 3 vaccines in human testing. When those advance into the next phase of human testing we might have a viable vaccine to use. ---
**Author:** ![Sunny\_Daze](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sunny_daze/32/438_2.png) [@Sunny\_Daze](https://boards.straightdope.com/u/Sunny_Daze)\ **Post date:** [April 18, 2020, 9:18pm UTC](https://boards.straightdope.com/t/so-what-should-i-know-about-remdesivir/851984/14 "2020-04-18T21:18:22Z")
> [@Magiver](#): > > That’s a great link and I thank you for it. But that isn’t just about drugs being tested. It’s about everything medical as it applies to the pandemic. And YAY. **We now have the power of supercomputers to sift through data. When the dust settles it will be exciting to see how fast things moved once the world put it’s shoulder into it.** We already have 3 vaccines in human testing. When those advance into the next phase of human testing we might have a viable vaccine to use. Bolding mine. I agree. It has been reassuring to see that humanity can pull together.