This preliminary case series of patients hospitalized with severe Covid-19 who were treated with compassionate-use remdesivir found that 68% showed clinical improvement. Ongoing randomized, placebo-controlled trials of remdesivir therapy should be followed.

Clinicians provided remdesivir on a compassionate-use basis to patients with Covid-19. They had to have an oxygen saturation of 94% or less while they were breathing ambient air or be receiving oxygen support. They received a 10-day course of remdesivir – 200 mg on day 1, followed by 100 mg daily for the remaining 9 days. Of the 53 patients whose data were analyzed, 22 were in the US, 22 in Europe or Canada, and 9 in Japan. Before treatment, 57% were on mechanical ventilation and 8% were receiving extracorporeal membrane oxygenation.

During a median follow-up of 18 days:

• 68% had an improvement in oxygen-support
• 57% receiving mechanical ventilation were extubated
• 47% were discharged
• 13% died