Remdesivir (GS-5734) in COVID-19 Therapy: The Fourth Chance

Background: Since its initial start in December 2019 at Wuhan, China, the coronavirus disease 2019 (COVID-19) has been rapidly spreading and labelled as a pandemic by the World Health Organization. The rate of human to human transmission of COVID-19 is far higher than severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome coronavirus (MERS). With no drugs or vaccines approved for the treatment of the disease, physicians have been using pre-existing drugs to curb the disease. One potential anti-viral agent currently undergoing numerous clinical trials is remdesivir, a nucleotide analog that inhibits RNA-dependent RNA polymerase of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Objective: In this mini-review, we provide an overview of remdesivir's journey, mechanism of action, pharmacokinetics, used in patients with COVID-19 under compassionate use principle and clinical trials to understand the effect of remdesivir in the treatment of patients with COVID-19. Conclusion: Initially, remdesivir was granted an emergency use authorization (EUA) by the U.S. Food and Drug Administration for the treatment of COVID-19 with severe disease. But now, remdesivir has been granted for use under EUA to treat all hospitalized COVID-19 patients, irrespective of their severity of disease.