Remdesivir improves biomarkers associated with disease severity in COVID-19 patients treated in an outpatient setting

Remdesivir is an intravenous antiviral with activity against SARS-CoV-2 for treatment of hospitalized COVID-19 patients with moderate-to-severe disease. Recently, remdesivir was evaluated in high-risk, non-hospitalized patients with confirmed SARS-CoV-2 infection and was highly effective at preventing disease progression. Biomarkers associated with clinical outcomes have been identified for COVID-19, but few evaluated in context of antiviral treatment. Here, we assessed baseline biomarkers and the impact of remdesivir treatment on longitudinal biomarker readouts. Six well-known, inflammation-associated biomarkers were elevated at baseline in participants meeting the primary endpoint of hospitalization or death by day 28. Moreover, in comparison to placebo, biomarkers in remdesivir-treated participants showed accelerated improvement, including reduction of soluble angiopoietin-2, D-dimer, and neutrophil-to-lymphocyte ratio, as well as increased lymphocyte counts. These findings have implications for better understanding the activity of antiviral treatments in COVID-19.