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Oct 25, 20205 min read

Potential COVID-19 Treatments

Bite-Sized Science would like to thank the following individuals’ for their contributions in the following article- providing the research, dissemination and basis of research on remdesivir: Abarnaa Illango, Diya Ahmad, Jen Ryu, Josephine Ding, Kruti Modi, Michelle Kim, Richard Liu, Preston Tse.


In the midst of the current COVID-19 pandemic, something that is perhaps at the forefront of many people’s and researchers' minds is when might a vaccine or effective treatment be developed. In this blog post, we’ll be covering one of the most prominent treatments to date, Remdesivir, as well as the current progress of COVID-19 vaccinations to date.


To start, we’ll begin by covering a drug that you may have heard of on the news or in the headlines over the past few months- and that would be none other than remdesivir.


Created by Gilead Sciences, remdesivir is an antiviral treatment that aims to prevent viral replication of SARS-CoV-2. Speaking broadly, its mechanism of action can be explained by the fact that this drug closely resembles adenosine, one of the four main nucleotides in RNA/DNA. In turn, our bodies mistake the drug for adenosine and incorporate remdesivir to a growing viral RNA strand of SARS-CoV-2, stopping the virus in its tracks.


Chemically and structurally, we can see that adenosine and remdesivir have very similar structures, as depicted in the following figure. A special section of remdesivir, known as the protide piece contains both an ester and amine group. These groups make the protide piece less polar, allow remdesivir to cross the cell membrane.

Remdesivir was granted an FDA Emergency Use Authorization on 1 May 2020, allowing it to be distributed in the U.S. and administered intravenously to treat suspected or laboratory-confirmed cases of COVID-19 for patients hospitalized with severe disease. This decision was made based on preliminary results on April 27 during an interim data analysis of the clinical trial, as patients who received remdesivir demonstrated a 31% faster time of recovery than those who received placebo. The emergency use for authorization was then expanded to include those with less severe forms of COVID-19, after results showed that there was moderate benefit. On July 27, 2020, Health Canada followed suit by authorizing use of remdesivrir to treat patients with COVID-19 and pneumonia requiring supplemental oxygen. As of October 22nd, remdesivir has been officially approved by the FDA for the treatment of COVID-19 requiring hospitalization.


In a typical drug patent timeline, it takes years, if not decades before the drug can be sold on market- undergoing rigorous testing on cell cultures, animals and human clinical trials before it can be determined whether or not its benefits outweigh the side effects. Amidst the urgency of the ongoing pandemic, the testing and use of remdesivir has been greatly expedited, however, the drug is still in its early stages and it remains uncertain whether or not it is effective in treating SARS-CoV-2. The effectiveness of remdesivir has yet to be validated, as one randomized, double-blind trial published on April 29, 2020 found that remdesivir was not associated with a significant difference in time to clinical improvement.

Despite remdesivir showing some benefits against COVID-19, if it were to be approved for widespread use, distribution and administration would prove to be somewhat difficult. Aforementioned, remdesivir is administered intravenously- therefore, it requires a healthcare professional to administer this drug, which may be a barrier for many worldwide.

Fun fact: remdesivir was not developed specifically for SARS-CoV-2. In fact, its origins begin in 2009 where research on treatments for hepatitis C (HCV) and respiratory syncytial virus (RSV) began.


Beyond drug treatments, other options being explored include rapidly ongoing research into vaccines for COVID-19 are also concurrently being tested alongside the search for a treatment, with an estimation by experts that a vaccine will be developed sometime mid 2021. Roughly 140 vaccines are currently in early development, with several of them are being tested in clinical trials. Unlike drug treatments, no vaccines have currently been approved for use against COVID-19 to date, and similarly to drugs, the vaccine timeline typically takes years to develop- the fastest development of a vaccine being 4 years for the mumps.


Although vaccines have been regarded as a promising way to end this pandemic, it’s important to keep in mind that it isn’t the perfect cure-all solution. It’s important to note that not vaccines are created equally- some can either prevent, reduce or eliminate individuals from getting infection, while others reduce the severity of the disease. And while vaccines can help a population towards achieving herd immunity (which refers to when enough individuals in a population are immune to a disease, the disease is much harder to spread), it only works when a majority of the population- around 80%- are vaccinated or have immunity. There’s also yet another catch- similarity to remdesivir, production, distribution and administration of vaccines pose yet another barrier to its implementation and applicability worldwide.


Another intervention that has been approved for emergency use against COVID-19 is convalescent plasma. Essentially, those who have recovered from COVID donate their plasma (a liquid component of blood) to those who currently have the virus. This is done because plasma contains antibodies, which recognize specific viruses or bacteria and may help the plasma recipient fight off the virus.


For those interested in more information on current progress on either vaccines or drug treatments for COVID-19, Bite-Sized Science recommends checking out the following two resources:

 

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