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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19), which is a respiratory disease that is capable of progressing to viral pneumonia and acute respiratory distress syndrome (ARDS); COVID-19 can be fatal. Like other RNA viruses, SARS-CoV-2 depends on an RNA-dependent RNA polymerase (RdRp) enzyme complex for genomic replication, which can be inhibited by a class of drugs known as nucleoside analogues. Remdesivir (GS-5734) is an adenosine triphosphate analogue first described in the literature in 2016 as a potential treatment for Ebola.[A191379, A222393] Broad antiviral activity of remdesivir is suggested by its mechanism of action, and to date, it has demonstrated in vitro activity against the Arenaviridae, Flaviviridae, Filoviridae, Paramyxoviridae, Pneumoviridae, and Coronaviridae viral families. Remdesivir activity against the Coronaviridae family was first demonstrated in 2017, leading to considerable interest in remdesivir as a possible treatment for COVID-19.[A191427, A198810] Remdesivir was confirmed as a non-obligate chain terminator of RdRp from SARS-CoV-2 and the related SARS-CoV and MERS-CoV, and has been investigated in multiple COVID-19 clinical trials.[L12174, L12177] Based on aggregate data, remdesivir was granted an FDA Emergency Use Authorization (EUA) on May 1st, 2020. The FDA subsequently granted full approval for remdesivir as a COVID-19 treatment on October 22, 2020, while simultaneously updating the EUA to cover those patients not included under the approved indication. Remdesivir is currently marketed under the trademark name VEKLURY® by Gilead Sciences Inc. Remdesivir in combination with baricitinib for the treatment of COVID-19, was granted an FDA Emergency Use Authorization on 19 Novermber 2020.

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