Patients and physicians worldwide are facing tremendous health care hazards that are caused by the ongoing severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) pandemic. Remdesivir (GS-5734) is the first approved treatment for severe coronavirus disease 2019 (COVID-19). It is a novel nucleoside analog with a broad antiviral activity spectrum among RNA viruses, including ebolavirus (EBOV) and the respiratory pathogens Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV, and SARS-CoV-2. First described in 2016, the drug was derived from an antiviral library of small molecules intended to target emerging pathogenic RNA viruses. In vivo, remdesivir showed therapeutic and prophylactic effects in animal models of EBOV, MERS-CoV, SARS-CoV, and SARS-CoV-2 infection. However, the substance failed in a clinical trial on ebolavirus disease (EVD), where it was inferior to investigational monoclonal antibodies in an interim analysis. As there was no placebo control in this study, no conclusions on its efficacy in EVD can be made. In contrast, data from a placebo-controlled trial show beneficial effects for patients with COVID-19. Remdesivir reduces the time to recovery of hospitalized patients who require supplemental oxygen and may have a positive impact on mortality outcomes while having a favorable safety profile. Although this is an important milestone in the fight against COVID-19, approval of this drug will not be sufficient to solve the public health issues caused by the ongoing pandemic. Further scientific efforts are needed to evaluate the full potential of nucleoside analogs as treatment or prophylaxis of viral respiratory infections and to develop effective antivirals that are orally bioavailable.

中文翻译：

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逆转录病毒抗COVID-19和其他病毒性疾病

全球范围内的患者和医生正面临着由持续严重的严重急性呼吸窘迫综合症冠状病毒2（SARS-CoV-2）大流行所引起的巨大医疗保健危害。Remdesivir（GS-5734）是第一种批准的2019年严重冠状病毒病（COVID-19）治疗药物。它是一种新型的核苷类似物，在包括埃博拉病毒（EBOV）和呼吸道病原体中东呼吸综合征冠状病毒（MERS-CoV），SARS-CoV和SARS-CoV-2在内的RNA病毒中具有广泛的抗病毒活性谱。该药物于2016年首次描述，衍生自旨在针对新兴病原性RNA病毒的小分子抗病毒文库。体内，remdesivir在EBOV，MERS-CoV，SARS-CoV和SARS-CoV-2感染的动物模型中显示出治疗和预防作用。但是，该物质在埃博拉病毒病（EVD）的临床试验中失败了，在中期分析中该物质不如研究性单克隆抗体。由于本研究中没有安慰剂对照，因此无法得出有关其在EVD中疗效的结论。相反，来自安慰剂对照试验的数据显示对COVID-19的患者有益。Remdesivir减少了需要补充氧气的住院患者的康复时间，并可能对死亡率产生积极影响，同时具有良好的安全性。尽管这是对抗COVID-19的重要里程碑，批准这种药物不足以解决持续的大流行引起的公共卫生问题。需要进一步的科学努力来评估核苷类似物作为治疗或预防病毒性呼吸道感染的全部潜力，并开发出口服生物利用的有效抗病毒药。