Nice

I have lost track, but how readily available is it?

Some real good news.

still curious when the remdesivir was administered in this study

on positive confirmed COVID test after hospital admission?

how sick were they when they started getting dosed?

cone said:

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still curious when the remdesivir was administered in this study

on positive confirmed COVID test after hospital admission?

how sick were they when they started getting dosed?

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Severe disease in hospitalized patients. This isn't a medication that can be given as an outpatient.

understood

would still like to see the tables of symptoms and panels before the drug was pushed

how is this study different from the China study?

and was it more effective for the younger cohort and how much more effective?

Isn't the development of an effective therapy (perhaps this drug and others that Fauci says could come from this approach) the key to things getting back to "normal", moreso than a vaccine and/or widespread (asymptomatic) testing?

Would these trial patients be considered "critical" or "severe"

Of confirmed cases, where do you think we are regarding % progressing to advanced disease? 5%?

Infection_Ag11 said:

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Lester Freamon said:

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I was thinking 8% mortality was still pretty bad, but if that's 8% mortality on ICU pts that's really good.

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The cohort is patients with advanced disease, 8% is indeed pretty damn good

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What's the mortality of ICU patients for patients without the drug?

i think control group was 11%

Lester Freamon said:

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Of confirmed cases, where do you think we are regarding % progressing to advanced disease? 5%?

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Depends on how you define severe. If it's patients requiring hospitalizations and any form of supplemental O2 probably around 10%. If it's patients requiring high flow/NIPPV and ICU monitoring somewhere around 5%. Intubation probably around 1%, and once you're intubated mortality is at least 50% at most centers and much higher at some. Overall mortality will probably settle out around 0.4-0.5% once we have a good idea of the minimal/asymptomatic disease burden with an accurate widespread serology test.

goodAg80 said:

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Nice

I have lost track, but how readily available is it?

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It has 5 or 6 chiral centers. One of them is at phosphorus, as part of a phosphate linkage. This center probably likes to invert. It looks like a molecule that organic synthesis graduate student could put together a decent retrosynthesis for making. I'd bet it's moderate level difficulty to produce, but would be a bear to scale up in short order. I'm guessing Gilead would be happy to "help."

While obviously a very positive development, hopefully this study leads to a treatment which is more effective and accessible, and less expensive, than Remdesivir.

94chem said:

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goodAg80 said:

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Nice

I have lost track, but how readily available is it?

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It has 5 or 6 chiral centers. One of them is at phosphorus, as part of a phosphate linkage. This center probably likes to invert. It looks like a molecule that organic synthesis graduate student could put together a decent retrosynthesis for making. I'd bet it's moderate level difficulty to produce, but would be a bear to scale up in short order. I'm guessing Gilead would be happy to "help."

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I understand some of these words.

Quote:

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If it's patients requiring hospitalizations and any form of supplemental O2 probably around 10%.

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i hate to step on your positivity with regard to IFR being sub 1%

but the NYC hospitalizations have been about 4x the number of deaths

serology study seemed to point to IFR being in the 1% range and hospitalizations in the 4%, across all ages

i know you were discussing confirmed vs. serology results, but the deaths vs. ever hospitalized (at least in NYC) seems like a mature ratio at this point in the epidemic

culdeus said:

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94chem said:

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goodAg80 said:

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Nice

I have lost track, but how readily available is it?

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It has 5 or 6 chiral centers. One of them is at phosphorus, as part of a phosphate linkage. This center probably likes to invert. It looks like a molecule that organic synthesis graduate student could put together a decent retrosynthesis for making. I'd bet it's moderate level difficulty to produce, but would be a bear to scale up in short order. I'm guessing Gilead would be happy to "help."

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I understand some of these words.

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Happy and Help.

goodAg80 said:

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culdeus said:

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94chem said:

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goodAg80 said:

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Nice

I have lost track, but how readily available is it?

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It has 5 or 6 chiral centers. One of them is at phosphorus, as part of a phosphate linkage. This center probably likes to invert. It looks like a molecule that organic synthesis graduate student could put together a decent retrosynthesis for making. I'd bet it's moderate level difficulty to produce, but would be a bear to scale up in short order. I'm guessing Gilead would be happy to "help."

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I understand some of these words.

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Happy and Help.

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Tough to make on large scale quicky. My 2 cents. And not something you'd want to mess up. Likely some very toxic mistakes lurking.

Looks like about a 10 step synthesis. I've never gone more than 6, and I didn't feed the product to anybody. Hardcore labs will go 30+ on some things, but I don't know if there are any commercial examples - mostly for an academic tour de force.

good news but...i suspect lot of doctors know that anecdotally...

another is this comes in IV and its only in ICU setting...good that it is effective...but

Now we need something for majority to either lessen the lethality or duration, once we get exposed...

My understanding is Thermo Fisher makes this for Gilead in their division that used to be a company called Patheon. Not sure on scale up capability.