Clinical benefit of remdesivir in rhesus macaques infected with SARS-CoV-2

Background: Effective
therapeutics to treat COVID-19 are urgently needed. Remdesivir is a nucleotide
prodrug with in vitro and in vivo efficacy against coronaviruses. Here, we
tested the efficacy of remdesivir treatment in a rhesus macaque model of SARS-CoV-2
infection.

Methods: To
evaluate the effect of remdesivir treatment on SARS-CoV-2 disease outcome, we
used the recently established rhesus macaque model of SARS-CoV-2 infection that
results in transient lower respiratory tract disease. Two groups of six rhesus
macaques were infected with SARS-CoV-2 and treated with intravenous remdesivir
or an equal volume of vehicle solution once daily. Clinical, virological and
histological parameters were assessed regularly during the study and at necropsy
to determine treatment efficacy.

Results: In
contrast to vehicle-treated animals, animals treated with remdesivir did not
show signs of respiratory disease and had reduced pulmonary infiltrates on radiographs.
Virus titers in bronchoalveolar lavages were significantly reduced as early as
12hrs after the first treatment was administered. At necropsy on day 7 after
inoculation, lung viral loads of remdesivir-treated animals were significantly
lower and there was a clear reduction in damage to the lung tissue.

Conclusions: Therapeutic remdesivir treatment initiated early during infection has a clear clinical benefit in SARS-CoV-2-infected rhesus macaques. These data support early remdesivir treatment initiation in COVID-19 patients to prevent progression to severe pneumonia.

Dataset supports publication:Williamson, B.N., Feldmann, F., Schwarz, B. et al. Clinical benefit of remdesivir in rhesus macaques infected with SARS-CoV-2. Nature (2020). https://doi.org/10.1038/s41586-020-2423-5

Also previously shared on bioRxiv: https://doi.org/10.1101/2020.04.15.043166