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Difference Between Remdesivir and Dexamethasone

Remdesivir is a drug developed for other viral infections that also works for treating Covid-19 patients. Dexamethasone is a type of steroid that has shown promise in treating and helping patients who have severe Covid-19 infections. 

What is Remdesivir?

Definition:

Remdesivir was made to treat infections caused by respiratory viruses and recently it has also been tested on patients who have Covid-19.

Mechanism of action:

Remdesivir attacks the enzyme directly involved in replication of the Covid-19 virus. This is the RNA polymerase enzyme that is involved in nucleic acid replication reactions.  Molecular reactions require specific enzymes, which is why inhibiting this specific enzyme leads to a breakdown in the process of viral genome replication.

What it is used for:

The medicine was initially made to fight respiratory syncytial virus and certain strains of the hepatitis virus. However, it has helped against other respiratory infections, including Covid-19 infections. 

Use for Covid-19 treatment

It has been found that Covid-19 patients who receive Remdesivir recover much faster than those who do not receive this treatment. This medicine allows the patient to more quickly overcome the infection, leading to shorter hospitalization times. The NIH recommends the use of Remdesivir for patients who are in hospital and requiring extra oxygen, but the drug is not advised for patients who are not severely ill with Covid-19.

Side effects:

There are a range of side effects associated with Remdesivir including feeling lightheaded, fever and chills, shortness of breath, and vomiting.

What is Dexamethasone?

Definition:

Dexamethasone is a medication that is a type of corticosteroid used for treating certain autoimmune conditions and that has now been used to also treat patients with Covid-19.

Mechanism of action:

The medicine works by reducing the output of chemicals that trigger inflammation and help by stopping the action of various types of cells involved in the body’s inflammatory response.

What it is used for:

Dexamethasone is used to treat conditions such as allergies and asthma. It is also useful for helping people who have autoimmune diseases such as rheumatoid arthritis since it helps suppress the immune response. It is also now used for treating patients with Covid-19. 

Use for Covid-19 treatment

It has been used to treat patients who have Covid-19 and has decreased the death of people with severe Covid by 30%.  It seems to work best for people who have respiratory failure due to their Covid-19 infection. Some scientists suggest the best strategy for use in treating coronavirus is to use the drug for a short time only because during recovery the concern is that it may suppress the immune response too much. In hospitalized patients, the death rate was significantly lower after 28 days for patients who got Dexamethasone than those who did not get the drug. The NIH recommends use of this drug for patients needing extra oxygen in the hospital and they also advise combining Dexamethasone with Remdesivir where patients are showing increasingly high levels of inflammation it the body and needing more oxygen.

Side effects:

Side effects of Dexamethasone include stomach irritation, nausea and vomiting. Patients may also experience dizziness, head pain, depression and not be able to sleep in some cases. 

Difference between Remdesivir and Dexamethasone?

Definition

Remdesivir is a medication that is used against respiratory viruses including Covid-19. Dexamethasone is a type of corticosteroid medication used to treat autoimmune illnesses and recently, Covid-19.

Molecule(s) or cells targeted

The molecule targeted by Remdesivir is an enzyme called RNA polymerase. The molecule targeted by Dexamethasone is cytokine, and it also stops the action of certain white blood cells involved in inflammation.

Mechanism of action

Remdesivir stops genome replication by impacting the specific polymerase enzyme that is required. Dexamethasone stops inflammation by stopping the white blood cells and the cytokines from being released.

Advantages

Advantages for Covid-19 patients is that they recover faster if given Remdesivir medicine; it also helps with other infections such as hepatitis. Advantages for Covid-19 patients who receive Dexamethasone is that it decreases the death rate of Covid-19 patients by 30% where the illness is severe and patients are on oxygen.

Disadvantages

There are sometimes side effects from taking Remdesivir such as fever and chills, dizziness, and vomiting. There are occasionally side effects from taking Dexamethasone and patients may end up with an upset stomach, nausea, depression, dizziness, and irritability.

Table comparing Remdesivir and Dexamethasone

Summary of Remdesivir Vs. Dexamethasone

  • Both Dexamethasone and Remdesivir have some positive effects for Covid-19 patients.
  • Both medications can be used together for patients in hospital with high levels of inflammation and high oxygen needs.
  • Dexamethasone targets the patient’s immune system to dampen the inflammatory response.
  • Remdesivir attacks the actual virus by inhibiting the RNA polymerase that is required for nucleic acid replication.
  • Both Remdesivir and Dexamethasone can have rather unpleasant side effects for some people.


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    References :


    [0]Beigel, John H., et al. "Remdesivir for the treatment of Covid-19." New England Journal of Medicine 383.19 (2020): 1813-1826.

    [1]Gordon, Calvin J., et al. "Remdesivir is a direct-acting antiviral that inhibits RNA-dependent RNA polymerase from severe acute respiratory syndrome coronavirus 2 with high potency." Journal of Biological Chemistry 295.20 (2020): 6785-6797.

    [2]Theoharides, T. C., and P. Conti. "Dexamethasone for COVID-19? Not so fast." J Biol Regul Homeost Agents 34.3 (2020): 10-23812.

    [3]Image credit: https://commons.wikimedia.org/wiki/File:Dexamethasone.jpg

    [4]Image credit: https://live.staticflickr.com/65535/49882602878_a19552ece8_b.jpg

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