The US drugmaker, Gilead Sciences has announced that it will soon initiate testing for the inhaled formulation of remdesivir (antiviral drug) used for the treatment of patients infected with COVID-19. The trials will begin in August.

Currently, this investigational drug has to be intravenously administered to patients through daily infusions in the hospital. An inhaled formulation would be given to the patients with the help of a nebulizer. This could potentially enable easier administration outside the hospital at earlier stages of COVID-19. This may have a substantial impact in aiding to stem the tide of the pandemic.

So far, in hospitalized patients, numerous randomized controlled trials have explored intravenous remdesivir's safety and efficacy. The screening will initiate soon for healthy volunteers to participate in phase 1 inhaled remdesivir trials.

In the US, a study by NIAID (National Institute of Allergy and Infectious Diseases) elucidated that remdesivir remarkably lowered recovery time by a mean average of 4 days. In another study of moderately ill hospitalized patients not requiring oxygen illustrated that patients receiving five days of a treatment course with remdesivir had better clinical outcomes in comparison to those who received standard care.

The data from the NIAID study also depicted that remdesivir treatment was most beneficial in patients who did not need any kind of mechanical ventilation support. This supports further study of the drug in patients in the early stages of coronavirus infection.

The inhaled formulation studies are one way of exploring the utilization of remdesivir in the earlier stages of SARS-CoV-2 infection. Trials will also be carried out utilizing intravenous infusions in various outpatient clinical settings (nursing homes and infusion centers). For patients who are at elevated risk of disease progression, it would be highly valuable to initiate treatment outside the hospital.

Early detection and intervention may help infected patients to avoid hospitalization. In the earlier stages of SARS-CoV-2 infection, the virus itself is the principal driver of illness. Therefore, it is crucial to have tools that can collaborate to combat both aspects of the disease: a therapy to mitigate the inflammatory response and an antiviral to target the virus itself.