Practical Info Route, dosage and duration: Additional considerations are available in three summaries of practical issues (remdesivir for COVID-19, administration of remdesivir for COVID-19, safety and monitoring in pa tients receiving remdesivir for COVID-19). Here follows a brief summary o f the key points:

• The recommended dose f or remdesivir is one dose daily as in travenous infusion. Remdesivir is given as 200 mg intravenously on da y 1, f ollowed by 100 mg in travenously on da ys 2–10. S horter regimens of 5 da ys are described in the smaller trials and local practice may be f ollowed.
• Administration should be as early as possible in the time c ourse of the disease.
• One should use caution when administering r emdesivir to patients with significant liver or kidney disease.
• The GDG no ted that there is insufficient evidence to make a recommendation around use in childr en and further studies are needed.
• Additionally, the trials did no t enrol pregnant or breastfeeding women. T he decision regarding use o f this therapeutic should be made be tween the pregnant person and their health car e provider while discussing whe ther the potential benefit justifies the potential risk to the mo ther and fetus (see Research evidence and WHO in formation sheet).

Resources and other considerations Acceptability and feasibility Remdesivir is administered as one in travenous infusion daily over 10 consecutive days, and rather than in an outpa tient setting, this is more easily operationalized in hospitalized patients with severe disease. Obstacles to access in LMICs due to c ost, feasibility and availability are of concern (30). Challenges in shared decisionmaking and in c ommunicating the harms v ersus benefits of remdesivir may also be incr eased in LMICs. T he recommendations should provide a stimulus to engag e all possible mechanisms to impr ove global access to the in tervention. As an e xample of this, on 17 D ecember 2021, WHO published the 8th invitation to M anufacturers of therapeutics against COVID-19 to submit an Expression of Interest (EOI) for Product Evaluation to the WHO P re-qualification Unit. If this evaluation demonstrates that a product and its c orresponding manufacturing (and clinical) site(s) meet WHO recommended standards, it will be included in the list o f medicinal products that are considered to be ac ceptable for procurement by UN organizations and o thers. Individual countries may formulate their guidelines considering available resources and prioritize treatment options accordingly.