key: cord-322044-4eejzpmn authors: Frediansyah, Andri; Nainu, Firzan; Dhama, Kuldeep; Mudatsir, Mudatsir; Harapan, Harapan title: Remdesivir and its antiviral activity against COVID-19: A systematic review date: 2020-08-07 journal: Clin Epidemiol Glob Health DOI: 10.1016/j.cegh.2020.07.011 sha: doc_id: 322044 cord_uid: 4eejzpmn BACKGROUND: To summarize the antiviral activities of remdesivir against SARS-CoV-2, the causative agent of COVID-19. METHODS: Available publications were systematically explored on some databases and gray literature was examined. Publications were discussed narratively. RESULTS: Remdesivir inhibits SARS-CoV-2 replication, reduces viral load, and exerts protective effects in SARS-CoV-2 infected animals. Remdesivir also reduces the pathological process, alleviates mild symptoms, and improves pulmonary lesions in SARS-CoV-2-infecetd animals. Although remdesivir has been used as a compassionate drug for treating COVID-19 patients, it has only moderate efficacy. CONCLUSION: Although remdesivir has shown potent antiviral activities, more efficacy assessments are urgently warranted in clinical trials. The current coronavirus disease 2019 (COVID-19) pandemic, has caused considerable 24 challenges to the national healthcare systems of most affected countries [1, 2] . The most [44] and it have been used to treat severe COVID-19 patients, as an emergency use [45] [46] [47] . Although only one clinical trial has been conducted to assess the effectiveness and safety of 73 remdesivir for COVID-19 [48] , several clinical trials are ongoing in some countries. Table 1 108 109 Remdesivir inhibits RdRp; its antiviral activity against RdRp has been reported in Huh7 [47] . Therefore, this information is insufficient to confirm the efficacy of remdesivir Table 2 173 174 The first randomized, double-blind, placebo-controlled, multicenter clinical trial was 175 reported on April 29, 2020 [48] . The study was conducted in China with 237 patients (158 176 in the remdesivir group and 79 in the placebo control group), and the primary endpoint 218 The authors declare that they have no competing interests. GS-335 5734) protects African green monkeys from Nipah virus challenge Comparative 338 therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and 339 interferon beta against MERS-CoV Prophylactic 341 and therapeutic remdesivir (GS-5734) treatment in the rhesus macaque model of 342 MERS-CoV infection Clinical benefit of remdesivir in rhesus macaques infected with SARS-CoV-2 A 347 randomized, controlled trial of Ebola virus disease therapeutics First case of 350 2019 novel coronavirus in the United States in critically ill patients in the Seattle region-case series Compassionate use 355 of remdesivir for patients with severe Covid-19 Remdesivir in adults with severe 358 COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial Remdesivir 361 and SARS-CoV-2: structural requirements at both nsp12 RdRp and nsp14 Exonuclease active-sites Learning from the past: possible urgent prevention 364 and treatment options for severe acute respiratory infections caused by 2019-nCoV Solidarity clinical trial for COVID-19 treatments Cytokine storm in 368 COVID-19: pathogenesis and overview of anti-inflammatory agents used in 369 treatment Remdesivir for COVID-19: challenges of underpowered studies Section I The authors whose names are listed immediately below certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. The authors whose names are listed immediately below report the following details of affiliation or involvement in an organization or entity with a financial or non-financial interest in the subject matter or materials discussed in this manuscript. Please specify the nature of the conflict on a separate sheet of paper if the space below is inadequate.