At present, there is no definitive antiviral treatment for coronavirus disease 2019 (COVID-19). We describe our early experience with remdesivir in four critically ill COVID-19 patients. Patients received a 200 mg loading dose, followed by 100 mg daily intravenously for up to 10 days. All patients had been previously treated with other antivirals before remdesivir initiation. One patient experienced a torsade de pointes requiring cardiac resuscitation and one died due to multiple organ failure. Three patients showed biochemical signs of liver injury. Lymphocyte count increased in all patients soon after remdesivir initiation. Nasal swab SARS-CoV-2 RNA became negative in three of four patients after 3 days of therapy. We observed an in vivo virological effect of remdesivir in four critically ill, COVID-19 patients, coupled with a significant burden of adverse events. Although limited by the low number of subjects studied, our preliminary experience may be relevant for clinicians treating COVID-19.

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瑞德西韦治疗 SARS-CoV-2 肺炎的早期经验

目前，没有针对 2019 年冠状病毒病 (COVID-19) 的明确抗病毒治疗方法。我们描述了我们在四名重症 COVID-19 患者中使用瑞德西韦的早期经验。患者接受 200 mg 负荷剂量，然后每天静脉注射 100 mg，持续长达 10 天。所有患者在开始使用瑞德西韦之前都曾接受过其他抗病毒药物的治疗。一名患者出现尖端扭转型室性心动过速，需要进行心脏复苏，一名患者因多器官衰竭而死亡。3名患者出现肝损伤的生化迹象。开始使用瑞德西韦后不久，所有患者的淋巴细胞计数均增加。治疗 3 天后，四名患者中有三名的鼻拭子 SARS-CoV-2 RNA 变为阴性。我们在四名重症 COVID-19 患者中观察到瑞德西韦的体内病毒学效应，加上严重的不良事件负担。尽管受到研究对象数量少的限制，但我们的初步经验可能与治疗 COVID-19 的临床医生相关。