An Open-Label Feasibility Study of Remdesivir in Long COVID: Results from the ERASE LC Trial

Objective: Treatment of acute COVID-19 with anti-viral and immunomodulator medications demonstrates a reduced risk of long-term outcomes. To date, remdesivir, an intravenous (IV) antiviral that prevents RNA transcription, has not been evaluated in people with Long COVID (LC). This study assessed the feasibility of a five-day IV remdesivir intervention for individuals with LC. Methods: Seventy-three participants aged [≥]18 years with a confirmed LC diagnosis were recruited across two sites in the United Kingdom to receive a five-day course of IV remdesivir. Primary feasibility outcomes included recruitment, treatment completion, acceptability, and safety. Exploratory patient-reported (e.g. Fatigue Assessment Scale [FAS]) and clinical outcomes (e.g. 6-minute walk test [6MWT]) were also collected. Results: Of 106 individuals screened, 73 were enrolled and 71 (97%) completed the 5-day IV remdesivir regimen. Follow-up assessments were completed by 70 participants (96%), with high completion rates observed across clinical assessments, patient-reported outcomes and symptom tracking. No severe adverse reactions were reported. Improvements were also observed in several exploratory patient-reported and clinical outcomes. Conclusion: We demonstrated the feasibility and acceptability of administering IV remdesivir in people with LC. Analysis of secondary outcomes suggests therapeutic promise, but rigorous evaluation in large-scale randomised controlled trials is essential to determine the true efficacy and clinical utility of intravenous remdesivir in this population.