Coronavirus COVID-19 Update for April 30, 2020

Pulmonary Embolism and Increased Levels of d-Dimer in Patients with Coronavirus Disease
Authors report 3 patients with coronavirus disease who had a decline in respiratory status during their hospital course that responded well to intravenous steroids and interleukin-6 receptor antagonist therapy. These patients later showed development of persistent hypoxia with increased levels of d-dimer levels and were given a diagnosis of pulmonary embolisms.

Adaptive COVID-19 Treatment Trial “ACTT” (NIAID)
RESULTS (N=1063)
- Primary Endpoint: Median time to recovery was 11 days for patients treated with remdesivir compared with 15 days for those who received placebo (p<0.001)
- Mortality rate of 8.0% for the group receiving remdesivir versus 11.6% for the placebo group (NS, p=0.059)
SIMPLE I Trial results (Gilead)
RESULTS (N~400)
- Similar improvement in clinical status for 5-day course vs 10-day course of treatment
No placebo control
Remdesivir in Chinese adults with severe COVID-19
RESULTS (237 patients were enrolled and randomly assigned to a treatment group; 158 to remdesivir and 79 to placebo)
- Stopped prior to full enrollment due to slow patient enrollment
- Remdesivir use was not associated with a difference in time to clinical improvement (hazard ratio 1·23 [95% CI 0·87–1·75]).
- Mortality 14% Remdesivir, 13% placebo
- Remdesivir did not result in significant reductions in SARS-CoV-2 RNA loads compared to placebo in upper respiratory tract or sputum specimens