The United Nations Office at Geneva
Multimedia Newsroom
COVID-19: UN health agency issues conditional advice against using remdesivir
Patients with COVID-19 should not be given the antiviral drug remdesivir “regardless of disease severity”, the UN World Health Organization (WHO) said on Friday.
Nonetheless, describing its recommendation as “conditional”, as opposed to “strong”, WHO stressed that data from a global trial on the efficacy of remdesivir was inconclusive, and that further trials should continue into its use for more vulnerable patients.
“We recommend a conditional recommendation – I want to highlight that - against the use of remdesivir in hospitalised patients with COVID-19 regardless of disease severity,” said Dr Janet Diaz, Head of Clinical Care at WHO, during a virtual press conference in Geneva.
According to data from the WHO-led Solidarity trial which was then examined by a panel of international experts behind the recommendation, “possibly remdesivir can lead to 29 fewer deaths per 1,000 patients or up to 11 more deaths per 1000 patients”, Dr Diaz said. “So you can see that …the confidence interval are relatively large…there was no evidence that there was any important effect on mortality, on the need for mechanical ventilation or the time to clinical improvement.”
But this did “not prove” that the antiviral “had no benefit at all”, Dr Diaz insisted. “There could still be potential small benefit, maybe in a health sub-group which is why the panel also recommended continued trials, continued enrolment into clinical trials.”
The WHO official explained that this might be “severe patients versus critical patients” or whether the antiviral is used “early versus late”.
Dr Bram Rochwerg, who was among the experts advising WHO, noted that there would likely be regional “variations” in the use of remdesivir.
While a minority of people will still choose to use it, the majority would not, based on the available data, he said.
“There may be groups (who might benefit) and the data was a bit more of a close call, so that’s why we felt strongly that trials need to continue using remdesivir and studying remdesivir and looking to see if there are specific groups that might, that might benefit,” he said. “We were very explicit that we do believe that these studies need to continue (and) Solidarity is continuing.”
Although the remdesivir development mirrors similar attempts to use other antivirals against the new coronavirus, Dr Diaz said there was no reason to lose hope in the fight against COVID-19.
“I do think there is a tremendous global effort to investigate treatments. You know, I think a lot of interest was done upfront with the repurposed of drugs, repurposed antivirals, you know we saw that with other repurposed drugs such as hydroxychloroquine, lopinavir, and there was a big push to try to test these and they’ve been tested and unfortunately, we just haven’t, you know, the results haven’t been as promising as we had hoped. But I don’t want to forget that we do have one lifesaving drug and even though it’s a repurposed old, old drug dexamethasone, a corticosteroid, we do know that that does reduce mortality, save lives of patient with severe and critical so there is something.”
Latest data from WHO indicates that eight in 10 people infected with COVID report mild symptoms, Dr Diaz said.
“Since the beginning (of the pandemic)…about 80 per cent of people have, you know, mild disease, a proportion maybe moderate disease and then only a small proportion, a smaller proportion, 20 per cent go on to develop severe or critical disease, and critical disease is a small, small portion, it’s five per cent or less, and that is…and that seems to be kind of consistent I think through the literature so most patients do have, if they have mild disease, self-limiting disease, they get better on their own, their immune system kicks in and they get better.”
Nonetheless, there are reports of more “persistent longer-term symptoms”, Dr Diaz noted. “So even though they don’t get severe disease there can be some persistent symptoms that lasts longer than one would have hoped for.”
- SOUNDBITE (English) — Dr Janet Diaz, Head of Clinical Care, WHO: “We recommend a conditional recommendation - so I want to highlight that, it’s a conditional recommendation - against the use of remdesivir in hospitalized patients - with COVID-19, regardless of disease severity.”
- SOUNDBITE (English) — Dr Janet Diaz, Head of Clinical Care, WHO: “Possibly remdesivir can lead to 29 fewer deaths par 1,000 patients or up to 11 more deaths per 1,000 patients so you can see that this is, the confidence interval is a little bit large.”
- SOUNDBITE (English) — Dr Janet Diaz, Head of Clinical Care, WHO: “It was not clear that, there was no evidence, that there was any important effect on mortality, on the need for mechanic ventilation or the time to clinical improvement.”
- SOUNDBITE (English) — Dr Janet Diaz, Head of Clinical Care, WHO: “This did not prove that remdesivir does not have a benefit at all and that’s why it is a conditional recommendation, there can still be potential small benefit, maybe in a health sub-group, which is why the panel also recommended continued trials, continued enrolment into clinical trials.”
- SOUNDBITE (English) — Dr Janet Diaz, Head of Clinical Care, WHO: “You know, is there a sub-group that may benefit more – such as severe patients versus critical patients. Is there a timing in disease that may benefit more - such as early versus late - and those are all considerations that are in the guidelines.”
- SOUNDBITE (English) — Dr Bram Rochwerg, practising ITU clinician and expert adviser for WHO-led Solidarity Trial: “There may be groups and the data was a bit more of a close call, so that’s why we felt strongly that trials need to continue using remdesivir and studying remdesivir and looking to see if there are specific groups that might, that might benefit. And as she said, we were very explicit that we do believe that these studies need to continue, Solidarity is continuing, so.”
- SOUNDBITE (English) — Dr Janet Diaz, Head of Clinical Care, WHO: “I do think there is a tremendous global effort to investigate treatments. You know, I think a lot of interest was done upfront with the repurposed of drugs, repurposed antivirals, you know we saw that with other repurposed drugs such as hydroxychloroquine, lopinavir, and there was a big push to try to test these and they’ve been tested and unfortunately, we just haven’t, you know, the results haven’t been as promising as we had hoped. But I don’t want to, I don’t want to forget that we do have one lifesaving drug and even though it’s a repurposed old, old drug dexamethasone, a corticosteroid, we do know that that does reduce mortality, save lives of patient with severe and critical so there is something.”
- SOUNDBITE (English) — Dr Janet Diaz, Head of Clinical Care, WHO: “Since the beginning, is that about 80 per cent of people have, you know, mild disease, a proportion maybe moderate disease and then only a small proportion, a smaller proportion, 20 per cent go on to develop severe or critical disease, and critical disease is a small, small portion, it’s five per cent or less, and that is…and that seems to be kind of consistent I think through the literature so most patients do have, if they have mild disease, self-limiting disease, they get better on their own, their immune system kicks in and they get better.”
- SOUNDBITE (English) — Dr Janet Diaz, Head of Clinical Care, WHO: “We do know that even patients with mild disease may have persistent longer-term symptoms. And that has been now described; so even though they don’t get severe disease there can be some persistent symptoms that lasts longer than one would have hoped for.”
Similar Stories
1
1
1
Edited News | OHCHR , UNOG
At the bi-weekly press conference in Geneva, Thameen Al-Kheetan, spokesperson for the Office of the UN High Commissioner for Human Rights, and Danielle Bell, head of UN Human Rights’ Ukraine team, spoke of the deepening impact of the war on the civilian population.
1
1
Edited News | OHCHR , UNOG
At the bi-weekly press briefing in Geneva, UN Human Rights Spokesperson Thameen Al-Kheetan made the following remarks Intensified Israeli attacks in Gaza.
1
1
1
Edited News | WHO
DR Congo: Ebola outbreak continues to expand, WHO sees signs of stabilization
In the Democratic Republic of the Congo (DRC), UN health teams and partners are still racing to contain the rapidly expanding Ebola outbreak, despite ongoing insecurity in eastern areas where the virus has taken hold. As of 19 July, the DRC Government has recorded 2,423 confirmed cases, including 967 deaths and 469 patient recoveries.
1
1
1
Edited News | OHCHR , UNOG
UN Human Rights spokeperson Jeremy Laurence appealed for calm in Pakistan-Administered Kashmir amid a wave of unrest ahead of regional elections at the end of the month.
1
1
1
Edited News | WFP
UN humanitarians working in war-torn Sudan warned on Friday of growing dramatic needs among the more than 100,000 displaced people now sheltering in camps in the city of El Obeid. "We are providing even not the full food ration to the people, but even that reduced food ration is being shared by the recipients with other families, because they know that they don't have any other source of income," said World Food Programme (WFP) Sudan Country Director Abdallah Alwardat.
1
1
1
Edited News | WHO
‘This is a fire’: DRC Ebola outbreak is fastest-growing ever, warns WHO
Infections of the Bundibugyo species of Ebola in the Democratic Republic of the Congo (DRC) have reached record highs and a majority of new cases are coming from “unknown chains of transmission”, the World Health Organization (WHO) warned on Tuesday.
1
1
1
Edited News | WHO
In war-torn Sudan, a deadly new cholera outbreak has already claimed more than 100 lives, heightening serious concerns for vulnerable communities including in besieged El-Obeid, where daily drone attacks reportedly continue to hamper aid access.
1
1
1
Edited News | UNIFIL
Ceasefire reduces violence in South Lebanon, but challenges remain as communities face devastation.
1
1
1
Edited News | WHO
Ebola continues to spread in DRC, death toll passes 500 – WHO
The outbreak of the deadly Bundibugyo species of Ebola in the eastern Democratic Republic of the Congo (DRC) is expanding, while the push to accelerate testing and identify effective treatment options continues, the UN World Health Organization (WHO) said on Tuesday.
2
1
2
Statements , Conferences , Edited News | ITU , ODET , PGA , UN , UNESCO
UN chief António Guterres appealed on Monday for far-reaching, worldwide controls on Artificial Intelligence, as increasingly powerful AI chips that are designed for civilian use shift to the battlefield, where “killer robots” are already the norm.
1
1
1
Edited News | OHCHR , UNOG
UN Human Rights Chief Volker Türk addressed the 62nd Human Rights Council during the Interactive Dialogue on Ukraine.
1
1
1
Edited News | WMO
More blistering heatwaves and other weather extremes are increasingly likely across the world now and in coming months linked to strengthening El Niño conditions in the tropical Pacific, the UN World Meteorological Organization (WMO) said on Friday.