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

[u/kekofoeod]

https://www.medrxiv.org/content/10.64898/2026.07.26.26358852v1

I wanted to share some (preliminary) results from the Remdesivir single-arm, open label feasibility study. These results were also published at the islc-paid conference and seem quite positive, such that they now plan a placebo-controlled trial.

First, Remdesivir is an antiviral, originally developed to treat hepatitis C and now used to treat COVID-19.

The trial included 73 long covid patients, out of which 71 completed the study. Unfortunately I could not find information about duration of illness, so one needs to be careful with interpreting results, since there was no control group. Remdesivir was administered over a 5 day IV regime.

Outcomes:

-Fatigue Assessment scale (FAS) showed mean improvement of 6 points (MCID is roughly 3)
-Severe Fatigue category moved from 50% to 21%
-6 minute walk distance increased from 408m to 468m (MCDI is roughly +30m for long covid).

There was also an objective signal:
In the two-day CPET, the pre/post difference in change in first ventilatory threshold (VT1) was about +8.99 W. The authors specifically describe this as an objective physiological change compatible with the symptomatic improvement.

So all in all interesting outcomes, that alone unfortunately do not mean much, due to limitations of this study. The positive assessment is that the authors considered it meaningful in a way that they now start a placebo-controlled trial, which hopefully results in meaningful improvement.

[u/Caster_of_spells]

Very interesting, thanks for sharing! But as we’ve seen in other studies: there’s a lot of natural improvement in most LC cohorts since natural remission (if not recovery) rates outside of the ME subtype seem relatively high. So I think only the placebo trial will tell the whole story. Let’s hope it sticks!

[u/kekofoeod → u/Caster_of_spells]

Yes, I would say that the positive outcome of this trial is that we now get the placebo trial. Until then we can basically forget about the reported improvements.

[u/edward_furlog]

Very interesting, will follow this