Remdesivir is a monophosphoramidate prodrug of an adenosine analogue and it has a
broad-spectrum antiviral activity against paramyxoviruses, falviviruses and coronaviruses. It
showed in vitro activity on human airway epithelial cells against SARS-CoV-2. It is an
investigational drug and granted an Emergency Use Authorization by Food and Drug
Administration FDA, so it is under clinical trial.
The potent mechanism of action of this drug is still unclear but it effects through several
processes. It can interfere with nsp12 polymerase even when exoribonuclease proofreading is
intact. It can also produce nucleoside triphosphate NTP that acts pharmacologically active
alternate substrate of RNA-chain terminator, as a result NTP can constrain active
triphosphates into viral RNA of coronaviruses. There is evidence of high genetic barrier to
develop resistance against Remdesivir in coronavirus as a result of which is maintains its
effectiveness in antiviral therapies against these viruses. Effectiveness of Remdesivir has
been reported against different groups of coronaviruses including Alphacoronavirus NL63 and
several SARS/MERS-CoV coronaviruses.