4 ms·

i'm very surprised to see remdesivir mentionned in this article at all... Isn't this drug officialy not working at all against covid-19 , and as such should be

by bsaul 6y ago

i'm very surprised to see remdesivir mentionned in this article at all... Isn't this drug officialy not working at all against covid-19 , and as such should be banned because of perfusion side-effects ? (in addition to the fact that it seems to be known to increase the amount of virus genetic mutations in people treated with it)

Robotbeat 6y ago
I’m as skeptical of your last parenthetical as you should be about remdesivir’s overall effectiveness. In any case, the effects are too small to matter.
inglor_cz 6y ago
Here in the Czech Republic, doctors in Brno are trying a combination of remdesivir and convalescent plasma in oncological Covid patients. They say that the combo has, so far, worked much better than either of the components in isolation. Out of the small cohort, they lost no one so far. Source in Czech: https://ct24.ceskatelevize.cz/jihomoravskykraj/3278822-brnenskym-lekarum-se-osvedcila-u-onkologickych-pacientu-s-covidem-kombinace https://ct24.ceskatelevize.cz/jihomoravskykraj/3278822-brnen...
- mfkp 6y ago
  That's the treatment that I got back in September in the US. I think they stopped using Remdesivir since then because it didn't correlate with any positive outcome. It also was destroying my liver, so they had to cut off the treatment halfway through. https://www.forbes.com/sites/jvchamary/2021/01/31/remdesivir-covid-coronavirus/?sh=621db3066c27 https://www.forbes.com/sites/jvchamary/2021/01/31/remdesivir...
  - inglor_cz 6y ago
    Maybe the total balance of results is better for immunosuppressed oncologic patients. Or maybe it is just a form of medical nationalism, given that the leader of the Remdesivir scientific team, Tomáš Cihlář, is a Czech scientist. We had some critical patients improve and heal on remdesivir, though. I wonder how big of a role genetic diversity plays. There are many uncertain suspicions that Covid hits some people harder than others based not just on lifestyle, but things such as blood groups. Research into that will be a good PhD material for years to come.
- nl 6y ago
  One thing I've learnt from the whole C19 treatment debacle is to never ever trust any single study. Unlike computer science where if you test something and it works once you and then you expect it to work for everyone, in medical research if you see an effect in one treatment study you probably won't see the same effect elsewhere. For treatments (unlike controlled vaccine studies) the cohorts are too small and there are too many other variables.
  - inglor_cz 6y ago
    Absolutely. The study may even be valid in certain conditions, but still fail to replicate elsewhere. People differ. Healthcare systems differ. Too many small details, too small to document, differ.
    - spyspy 6y ago
      Journalistic interpretation of these tiny, rushed studies has also been god awful since the beginning. This is true during the best of times, but every clickbait headlines spreading disinformation during an actual pandemic should not be tolerated, especially amongst the more reputable news sources (looking at you NYT).
      - erklik 6y ago
        This right here. If people look at the actual study, they'll see the number of caveats and various exact conditions where the study proved something, whereas the media tends to pretend that those caveats or conditions don't exist therefore, the study works everywhere. That's why people don't trust science, "oh, its probably wrong again".
        jxramos 6y ago
        That's a fascinating idea, the learned doubtfulness towards science due to its exaggerators.
        nl 6y ago
        This isn't always really true. Some of the worst offenders have been scientists, who promote their own studies (eg, the French hydroxychloroquine studies). It's possible to pick holes in these studies if you know the field. But these holes aren't pointed out in the papers themselves, and peer review doesn't stop this. Peer reviewers are experts in the field. So they know if they are looking at a 30 person study it isn't conclusive, and wouldn't expect the author to state that. It's just assumed the readers know that. We see the real impact of this with things like the Vitamin D studies. Experts know that Vitamin D deficiency is highly correlated with age and other health issues, but that the causation chain is "Person is unhealthy so doesn't get outside as much so gets less Vitamin D, and in some cases are deficient which can make health issues worse". Non-experts read the report and see the causation going the other way, ie, they think: "High Vitamin D fixes health issues".
marcodiego 6y ago
Isn't remdesivir being used only in cases of viral pneumonia on ICU patients?
- Asparagirl 6y ago
  No, my thirty-five-year old sister-in-law was given remdesivir twice during her stay in a Los Angeles hospital during the December wave, and while she had early stage covid pneumonia she was not in the ICU.
mike_d 6y ago
From what I understand Remdesivir doesn't show results in mortality, but has positive results in recovery speed of patients who otherwise would not have died. I believe it shaves about 5 days off the supplemental O2/ICU phase, which decreases the window in which you can develop other complications and also gets your butt out to free up hospital resources quicker. Mexico just issued an emergency use authorization yesterday. Japan, Canada, and the EU have also authorized the drug for COVID patients. You can read the NIH final report here: https://www.nejm.org/doi/full/10.1056/NEJMoa2007764 https://www.nejm.org/doi/full/10.1056/NEJMoa2007764

by bsaul 6y ago

Robotbeat 6y ago

I’m as skeptical of your last parenthetical as you should be about remdesivir’s overall effectiveness. In any case, the effects are too small to matter.

inglor_cz 6y ago

Here in the Czech Republic, doctors in Brno are trying a combination of remdesivir and convalescent plasma in oncological Covid patients. They say that the combo has, so far, worked much better than either of the components in isolation. Out of the small cohort, they lost no one so far. Source in Czech: https://ct24.ceskatelevize.cz/jihomoravskykraj/3278822-brnenskym-lekarum-se-osvedcila-u-onkologickych-pacientu-s-covidem-kombinace https://ct24.ceskatelevize.cz/jihomoravskykraj/3278822-brnen...

mfkp 6y ago
That's the treatment that I got back in September in the US. I think they stopped using Remdesivir since then because it didn't correlate with any positive outcome. It also was destroying my liver, so they had to cut off the treatment halfway through. https://www.forbes.com/sites/jvchamary/2021/01/31/remdesivir-covid-coronavirus/?sh=621db3066c27 https://www.forbes.com/sites/jvchamary/2021/01/31/remdesivir...
- inglor_cz 6y ago
  Maybe the total balance of results is better for immunosuppressed oncologic patients. Or maybe it is just a form of medical nationalism, given that the leader of the Remdesivir scientific team, Tomáš Cihlář, is a Czech scientist. We had some critical patients improve and heal on remdesivir, though. I wonder how big of a role genetic diversity plays. There are many uncertain suspicions that Covid hits some people harder than others based not just on lifestyle, but things such as blood groups. Research into that will be a good PhD material for years to come.
nl 6y ago
One thing I've learnt from the whole C19 treatment debacle is to never ever trust any single study. Unlike computer science where if you test something and it works once you and then you expect it to work for everyone, in medical research if you see an effect in one treatment study you probably won't see the same effect elsewhere. For treatments (unlike controlled vaccine studies) the cohorts are too small and there are too many other variables.
- inglor_cz 6y ago
  Absolutely. The study may even be valid in certain conditions, but still fail to replicate elsewhere. People differ. Healthcare systems differ. Too many small details, too small to document, differ.
  - spyspy 6y ago
    Journalistic interpretation of these tiny, rushed studies has also been god awful since the beginning. This is true during the best of times, but every clickbait headlines spreading disinformation during an actual pandemic should not be tolerated, especially amongst the more reputable news sources (looking at you NYT).
    - erklik 6y ago
      This right here. If people look at the actual study, they'll see the number of caveats and various exact conditions where the study proved something, whereas the media tends to pretend that those caveats or conditions don't exist therefore, the study works everywhere. That's why people don't trust science, "oh, its probably wrong again".
      - jxramos 6y ago
        That's a fascinating idea, the learned doubtfulness towards science due to its exaggerators.
      - nl 6y ago
        This isn't always really true. Some of the worst offenders have been scientists, who promote their own studies (eg, the French hydroxychloroquine studies). It's possible to pick holes in these studies if you know the field. But these holes aren't pointed out in the papers themselves, and peer review doesn't stop this. Peer reviewers are experts in the field. So they know if they are looking at a 30 person study it isn't conclusive, and wouldn't expect the author to state that. It's just assumed the readers know that. We see the real impact of this with things like the Vitamin D studies. Experts know that Vitamin D deficiency is highly correlated with age and other health issues, but that the causation chain is "Person is unhealthy so doesn't get outside as much so gets less Vitamin D, and in some cases are deficient which can make health issues worse". Non-experts read the report and see the causation going the other way, ie, they think: "High Vitamin D fixes health issues".

marcodiego 6y ago

Isn't remdesivir being used only in cases of viral pneumonia on ICU patients?

Asparagirl 6y ago
No, my thirty-five-year old sister-in-law was given remdesivir twice during her stay in a Los Angeles hospital during the December wave, and while she had early stage covid pneumonia she was not in the ICU.

mike_d 6y ago

From what I understand Remdesivir doesn't show results in mortality, but has positive results in recovery speed of patients who otherwise would not have died. I believe it shaves about 5 days off the supplemental O2/ICU phase, which decreases the window in which you can develop other complications and also gets your butt out to free up hospital resources quicker. Mexico just issued an emergency use authorization yesterday. Japan, Canada, and the EU have also authorized the drug for COVID patients. You can read the NIH final report here: https://www.nejm.org/doi/full/10.1056/NEJMoa2007764 https://www.nejm.org/doi/full/10.1056/NEJMoa2007764