Publication date: Aug 28, 2025
Background: Remdesivir is associated with hepatotoxicity and acute kidney injury (AKI). The objective of this study was to assess the hepatotoxicity and AKI with remdesivir. Method: This is a multicenter, retrospective cohort study for adult patients who used remdesivir for COVID-19 from 3/2020 to 10/2021. The study was conducted at Rhode Island Hospital, Rhode Island, United States. Data were analyzed with descriptive statistics as well as logistic regression analysis using STATA 18. Results: A total of 1635 patients were evaluated for hepatotoxicity: 337 developed hepatotoxicity, and 1298 had normal hepatic function. The overall median frequency of hepatotoxicity occurred in 319 patients (19. 5%). Patient age (OR 1. 02, 95% CI: 1-1. 04, p = 0. 02) and selective serotonin reuptake inhibitors (SSRIs) use (OR 1. 7, 95% CI: 1. 1-2. 6, p = 0. 01) were potential risk factors for remdesivir-associated hepatotoxicity. In contrast, being male gender was protective against remdesivir-associated hepatotoxicity (OR 0. 63, 95% CI: 0. 47-0. 87, p = 0. 02). The frequency of AKI with remdesivir occurred in 280 patients (17. 3%). Conclusions: The frequency of hepatotoxicity was 19. 5%, and the frequency of AKI was 17. 3%. Increasing age and using SSRIs were risk factors for remdesivir-associated hepatotoxicity, while male gender was a protective factor. Clinicians should vigilantly monitor hepatic and renal functions for patients using remdesivir, especially in elderly patients.
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| Concepts | Keywords |
|---|---|
| Basel | acute kidney injury |
| Hepatotoxicity | COVID-19 |
| Hospital | hepatotoxicity |
| Kidney | liver |
| remdesivir |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | Acute Kidney Injury |
| disease | MESH | COVID-19 |
| drug | DRUGBANK | Coenzyme M |
| disease | IDO | replication |
| disease | MESH | critically ill |
| disease | MESH | bradycardia |
| drug | DRUGBANK | Creatinine |