Resuming normal life in a world with coronavirus will depend on developing drugs that can effectively treat COVID-19 or a vaccine that can prevent infection by the SARS-CoV-2 virus that causes it, public health experts say. That’s made each announcement of a potential cure for the disease a cause of great excitement and, in some cases, reckless disregard for safety on the part of patients. 

Patients may ask you about reports of an antiviral medication, remdesivir, that could treat patients with COVID-19. Here’s where the drug stands and what’s sparking the discussion.

A study supported by remdesivir’s manufacturer, Gilead Sciences, Inc., of Foster City, California, was published in the New England Journal of Medicine on April 10. The cohort analysis demonstrated that the majority of 53 patients hospitalized with COVID-19 who were treated under “compassionate use,” not in a clinical trial, experienced clinical improvement. 

Two-thirds of patients on mechanical ventilation had improved oxygen levels following treatment, and almost half were discharged. Patients over age 70 years and those requiring invasive ventilation did not respond as well. Seven patients died. No significant safety issues arose. On April 16, Stat News reported that the drug appeared to be effective in patients with COVID-19, based on very early results from one institution participating in two large, multicenter, phase III clinical trials. The results were discussed by an investigator at University of Chicago Medicine in a private video leaked to the outlet.

The report indicated that 125 patients at the Chicago center, 113 of whom were severely ill, had received daily infusions of remdesivir. The drug rapidly reduced fever and respiratory symptoms. Many of the patients were released from the hospital in fewer than 7 days; two died. 

On Monday, National Institutes of Health scientists posted a preprint study, which has not yet been peer-reviewed, that indicated that remdesivir reduced symptoms and lung damage in rhesus macaques infected with SARS-CoV-2 starting from the first dose throughout a 7-day trial. The study followed the dosing and procedures being used in the large clinical trial in humans. 

While these studies provide reason for hope that remdesivir might alleviate respiratory symptoms in COVID-19, the results may not be as rosy as they seem at first glance. Patients in the human studies were in severe, not critical, condition, as the trials are designed to keep patients from getting to that point—not rescue them once they had. But that makes interpreting the results more challenging as only patients in critical condition die, based on studies from China, noted Jeremy Faust, MD, MS, in an analysis of the studies. So remdesivir may not be helping much at all. It’s really too early to say.

Interim results of the clinical trials, which are expected shortly, will clarify remdesivir’s real impact. The drug does not yet have and may still not receive FDA approval for the novel coronavirus or any other disease. So, tell your patients that right now there is no drug approved to treat COVID-19, and it isn’t clear one if be approved soon.

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