An open-label feasibility study of remdesivir in long COVID: results from the ERASE LC trial

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. 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. 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. 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. Trial registration: ClinicalTrials.gov NCT05911906.