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Editorial
. 2022 Jan 27;386(4):385-387.
doi: 10.1056/NEJMe2118579. Epub 2021 Dec 22.

The Goldilocks Time for Remdesivir - Is Any Indication Just Right?

Emily L Heil  1 , Shyam Kottilil  1
Affiliations
Editorial

The Goldilocks Time for Remdesivir - Is Any Indication Just Right?

Emily L Heil et al. N Engl J Med. .
No abstract available

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Figures

Figure 1
Figure 1. Current and Pending Therapeutics for Covid-19 in the United States.
Clinical strategies to reduce morbidity and mortality from coronavirus disease 2019 (Covid-19) are designed according to infection status and the stage of disease. First, for uninfected persons, one of three Covid-19 vaccinations is the most appropriate intervention to prevent development of Covid-19. Second, for those who have a high risk of progression to a more severe case of Covid-19, postexposure prophylaxis with combination neutralizing monoclonal antibodies can be used to preemptively abort development of infection. Third, for those who are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there are now multiple approaches to prevent hospitalization. These include neutralizing monoclonal antibodies against the SARS-CoV-2 spike protein and antivirals that block viral replication. This is a critical need that will have a great effect on our ability to curtail this pandemic. Finally, for hospitalized patients, there are antiviral options (remdesivir) and immunomodulator therapies that have been shown to reduce in-hospital mortality. Baricitinib and tocilizumab are indicated for patients with severe-to-critical Covid-19 and elevated markers of inflammation. Tofacitinib can be used instead of baricitinib, and sarilumab can be used instead of tocilizumab.
See this image and copyright information in PMC

Comment on

  • Early Remdesivir to Prevent Progression to Severe Covid-19 in Outpatients.
    Gottlieb RL, Vaca CE, Paredes R, Mera J, Webb BJ, Perez G, Oguchi G, Ryan P, Nielsen BU, Brown M, Hidalgo A, Sachdeva Y, Mittal S, Osiyemi O, Skarbinski J, Juneja K, Hyland RH, Osinusi A, Chen S, Camus G, Abdelghany M, Davies S, Behenna-Renton N, Duff F, Marty FM, Katz MJ, Ginde AA, Brown SM, Schiffer JT, Hill JA; GS-US-540-9012 (PINETREE) Investigators. Gottlieb RL, et al. N Engl J Med. 2022 Jan 27;386(4):305-315. doi: 10.1056/NEJMoa2116846. Epub 2021 Dec 22. N Engl J Med. 2022. PMID: 34937145 Free PMC article. Clinical Trial.

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