**3. Results**

These data are presented in Table 1. In patients who received remdesivir immediately after COVID-19 confirmation compared to no remdesivir, the time to negative PCR was not statistically different with a median duration of 57 days in both groups (*p* = 0.369). The change in the Ct between the first and the second PCR test was also not statistically different between groups with a median change of 18.4 cycles in the remdesivir group and 15.7 cycles without remdesivir (*p* = 0.516). The median time between two PCRs in the remdesivir group was 23 days and 27 days in the no remdesivir group.

**Table 1.** Baseline Variables and Outcomes.


All medians compared using Wilcoxon rank sums for non-parametric data; <sup>a</sup> Missing 9 data points in "no remdesivir" arm; <sup>b</sup> 7 patients in "remdesivir" arm and 5 patients in "no remdesivir" arm; <sup>c</sup> SARS-CoV-2 PCR testing was performed using the following assays based on which reagents were available at the time: TaqPath COVID-19 Combo Kit (ThermoFisher), cobas SARS-CoV-2 Test (Roche), Xpert Xpress SARS-CoV-2 (Cepheid), or a lab developed test adapted from the CDC SARS-CoV-2 assay.

#### **4. Discussion**

The Adaptive COVID-19 Treatment Trial (ACTT-1) demonstrated a reduced time to recovery with use of remdesivir [7]. The World Health Organization recently published their interim results of antiviral drugs for COVID-19. In this analysis, the authors describe 2750 patients who were randomized to treatment with remdesivir. They concluded that none of the drugs assessed, including remdesivir, had an effect on overall mortality, initiation of ventilation, or length of stay [3]. While these large studies utilized clinical endpoints, little is known about the effect of remdesivir on viral load. Clearance of virus with negative or high Ct PCR is often of increased importance regarding disposition and isolation requirements, immunosuppression regimens, and transplant listing [8]. The results of this small single-center analysis suggest that remdesivir may not be beneficial in shortening

time to a negative COVID-19 PCR. As far as the change between two cycle thresholds after beginning remdesivir, our data suggest no difference, however our sample is small and likely underpowered. Our data are inadequate to determine drug efficacy; and is limited by a small sample size. Nevertheless, it suggests that an unnecessary admission or prolonged hospitalization for the sole purpose of remdesivir administration may not warranted.

**Author Contributions:** Conceptualization, G.G., D.K. and R.J.W.; methodology, G.G., R.J.W. and J.C.; software, R.J.W. Validation, R.J.W. and G.G.; formal analysis, R.J.W. Investigation, R.J.W. and G.G.; data curation, S.S., D.K. and J.C.; writing—original draft preparation, R.J.W.; writing—review and editing, R.J.W., G.G., M.M., A.B., S.S. and D.K.; visualization, G.G.; supervision, G.G.; project administration, G.G. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Review Board of Virginia Commonwealth University as EXEMPT.

**Informed Consent Statement:** Not applicable.

**Data Availability Statement:** De-identified data may be made available upon formal request.

**Conflicts of Interest:** The authors declare no conflict of interest.
