New Paper (Therapeutic): Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro

Title: Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro

Please paste a link to the paper or a citation here:

Link: https://www.nature.com/articles/s41422-020-0282-0

What is the paper's Manubot-style citation?

Citation: doi:10.1038/s41422-020-0282-0

Please list some keywords (3-10) that help identify the relevance of this paper to COVID-19

Remdesivir
Chloroquine
2019-nCoV
in vitro

Which areas of expertise are particularly relevant to the paper?

[X] virology
[ ] epidemiology
[ ] biostatistics
[ ] immunology
[ ] pharmacology

Questions to answer about each paper:

Please provide 1-2 sentences introducing the study and its main findings

This is a Letter to Editor that describes the impact of remdesivir and cholorquine on the novel coronavirus in vitro.

Study question(s) being investigated:

The study evaluated the antiviral efficiency of 5 FDA-approved drugs against a clinical isolate of 2019-nCoV in vitro.

How many/what drugs/combinations are being considered?

The drugs included, ribavirin, penciclovir, nitazoxanide, nafamostat, choloroquine, remdesivir, and favipiravir.

What are the main hypotheses being tested?

Existing antiviral drug are effective in treating related viral infections.

What is the model system (e.g., human study, animal model, cell line study)?

African green monkey kidney Vero E6 cell line Human liver cancer Huh7 cell line

Sample size (e.g. number of technical and biological replicates, etc) were not included.

What is the sample size? If multiple groups are considered, give sample size for each group (including controls).

Different concentrations of ribavirin, penciclovir, nitazoxanide, nafamostat, choloroquine, remdesivir, and favipiravir.

Control, DMSO

Statistical Methods Assessment:

None described, this might be a concern?

What methods are used for inference?

None were described by the authors including in the supplemental files.

For example, logistic regression, nonparametric methods.

Are the methods appropriate for the study?

For example, are clustered data treated independently or are clusters adjusted for, such as different hospitals or litters?

Are adjustments made for possible confounders?

None described.

Results Summary:

Ribavirin, EC50 = 109.5 microMole, CC50 > 400 microMole, SI > 3.65 Penciclovir, EC50 = 95.96 microMole, CC50 > 33.52 microMole, SI > 6.46 Nitazoxanide, EC50 = 2.12 microMole, CC50 > 33.52 microMole, SI > 16.76 Nafamostat, EC50 = 22.50 microMole, CC50 > 100 microMole, SI > 4.44 Choloroquine, EC50 = 1.13 microMole, CC50 > 100 microMole, SI > 88.50 Remdesivir, EC50 = 0.77 microMole, CC50 > 100 microMole, SI > 129.87 Favipiravir, EC50 = 68 microMole

Both Choloroquine and Remdesivir blocked virus infection at low-micromolar concentration and showed a high SI. This was an in vitro study only.

This is a cell culture model, the authors used African green monkey kidney cells and human liver cancer cells. I think it might have been more applicable to use a lung cell type, since we know that the lungs are what is affected by this virus.

Summary of reliability

This is an interesting basic study science, where the researchers show that remdesivir and chloroquine have some impact on the 2019-nCoV in vitro. As mentioned above the monkey kidney and human cell lines were used.

Progress

[X] 1-2 sentences introducing the study and its main findings
[X] Describe How many/what drugs/combinations are being considered
[X] Describe the model system
[X] What is the sample size?
[X] Describe study setting
[X] Describe how treatments are assigned
[X] Describe methods used for inference
[X] Describe whether the methods are appropriate for the study
[X] If the study is an animal study, which animal and how relevant is that model?
[X] Summary of reliability

greenelab / covid19-review