Big for #COVID19 therapy: the compassionate use results for remdesivir in 53 patients looks very encouraging, especially in very sick patients on mechanical ventilation with 18% fatality (only, expect > 50%) and overall 68% improvement https://www.nejm.org/doi/pdf/10.1056/NEJMoa2007016?articleTools=true @NEJM

The previous reports of patients w/ #COVID19 who required intubation, on a ventilator, all have fatality rates >50%. That's historical controls from China, Italy, and the UK and go up to 93% fatality. We need more data for remdesivir but this really a good signal for efficacy.

Combine this clinical result with the structural biology from earlier today, pinpoint intervention (at atom level) of RdRp, the virus's replication and transcription machinery. Cool. Figure from that paper where R binds to the RNA-polymerase
https://twitter.com/EricTopol/status/1248618784828428288

The most important sentence in the @NEJM paper to signal this drug works

Here are the adverse events: the liver and kidney are notable.
Those who are responding "no controls" may also want to note that many of the events on the list occur in such acutely ill patients

I annotated the 53 patient chart (commend the authors/
@NEJM) to show the patients who'd been inubated w/ ventilator, now discharged, or intubated, still in hospital. You can see many are in latter category. We know these patients have very long ICU times
https://twitter.com/EricTopol/status/1247260880233836553

The @ICNARC data was updated today (Apr 10) with nearly 1700 ICU patients and the largest cohort followed, reported on a mechanical ventilator, to date. The mortality, if on a ventilator in the 1st 24 hrs, was nearly 70% (note lag of pending status, too)
https://twitter.com/EricTopol/status/1248731498359840768