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

Abstract 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.