{"id":18957,"date":"2020-06-01T04:53:04","date_gmt":"2020-05-31T20:53:04","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=18957"},"modified":"2020-07-14T16:14:47","modified_gmt":"2020-07-14T08:14:47","slug":"18957","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=18957","title":{"rendered":"[N Engl J Med\u5728\u7ebf\u53d1\u8868]\uff1a\u745e\u5fb7\u897f\u97e65\u5929\u621610\u5929\u7597\u7a0b\u6cbb\u7597\u91cd\u75c7\u65b0\u51a0\u75c5\u6bd2\u611f\u67d3\u60a3\u8005"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Remdesivir for 5 or 10 Days in Patients with Severe Covid-19<\/h1>\n\n\n\n

Jason D. Goldman, David C.B. Lye, David S. Hui, et al<\/h3>\n\n\n\n

N Engl J Med May 27, 2020
DOI: 10.1056\/NEJMoa2015301<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h3>\n\n\n\n

Remdesivir is an RNA polymerase inhibitor with potent antiviral activity in vitro and efficacy in animal models of coronavirus disease 2019 (Covid-19).<\/p>\n\n\n\n

METHODS<\/h3>\n\n\n\n

We conducted a randomized, open-label, phase 3 trial involving hospitalized patients with confirmed SARS-CoV-2 infection, oxygen saturation of 94% or less while they were breathing ambient air, and radiologic evidence of pneumonia. Patients were randomly assigned in a 1:1 ratio to receive intravenous remdesivir for either 5 days or 10 days. All patients received 200 mg of remdesivir on day 1 and 100 mg once daily on subsequent days. The primary end point was clinical status on day 14, assessed on a 7-point ordinal scale.<\/p>\n\n\n\n

RESULTS<\/h3>\n\n\n\n

In total, 397 patients underwent randomization and began treatment (200 patients for 5 days and 197 for 10 days). The median duration of treatment was 5 days (interquartile range, 5 to 5) in the 5-day group and 9 days (interquartile range, 5 to 10) in the 10-day group. At baseline, patients randomly assigned to the 10-day group had significantly worse clinical status than those assigned to the 5-day group (P=0.02). By day 14, a clinical improvement of 2 points or more on the ordinal scale occurred in 64% of patients in the 5-day group and in 54% in the 10-day group. After adjustment for baseline clinical status, patients in the 10-day group had a distribution in clinical status at day 14 that was similar to that among patients in the 5-day group (P=0.14). The most common adverse events were nausea (9% of patients), worsening respiratory failure (8%), elevated alanine aminotransferase level (7%), and constipation (7%).<\/p>\n\n\n\n

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CONCLUSIONS<\/h3>\n\n\n\n

In patients with severe Covid-19 not requiring mechanical ventilation, our trial did not show a significant difference between a 5-day course and a 10-day course of remdesivir. With no placebo control, however, the magnitude of benefit cannot be determined. (Funded by Gilead Sciences; GS-US-540-5773 ClinicalTrials.gov number, NCT04292899. opens in new tab<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"

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