Andreas Barratt-Due

Introduction Hyperactivation of the complement system has been suggested to be a central player in the pathogenesis of COVID-19. Early in the pandemic, we demonstrated that systemic complement activation was prevalent among the majority of 39 hospitalized COVID-19 patients, and that the soluble terminal complement complex, TCC (sC5b-9), was associated with respiratory failure (RF) [1].

HIGHLIGHTS • Remdesivir downregulates interferon responses in hospitalized COVID-19 patients • Treatment had a particularly strong effect on interferon γ • This response could be beneficial in mild, but not in severe disease • Treatment options in COVID-19 could differ according to disease severity Dear Editor, We have read with great interest the article by Lucijanic et al. that was recently published in Journal of Infection 1 Lucijanic M Cikara T Bistrovic P et al.

We read with interest the Comment by Iwein Gyselinck and Wim Janssens concerning the recently published DisCoVeRy trial,, 2 Ader F Bouscambert-Duchamp M Hites M et al. Remdesivir plus standard of care versus standard of care alone for the treatment of patients admitted to hospital with COVID-19 (DisCoVeRy): a phase 3, randomised, controlled, open-label trial. which concluded that given current evidence there is no reason to advocate remdesivir use outside clinical trials.