Remdesivir-Associated Acute Liver Failure in a COVID-19 Patient: A Case Report and Literature Review

Cureus. 2023 Jan 26;15(1):e34221. doi: 10.7759/cureus.34221. eCollection 2023 Jan.

Abstract

There is a broad classification of the causes of acute liver failure (ALF) that include drug-induced liver injury (DILI). In this report, we aim to discuss the association between remdesivir, a novel therapeutic drug for hypoxic coronavirus disease 2019 (COVID-19) pneumonia, and DILI with subsequent ALF in a patient who was recently treated with the drug in question. Remdesivir, which is a direct-acting nucleoside RNA polymerase inhibitor, is one of the only FDA-approved drugs on the market for COVID-19 pneumonia associated with hypoxia. Our case describes a patient with an extensive past medical history who was treated for COVID-19 pneumonia with remdesivir and subsequently developed ALF in the absence of all other possible etiologies. This association has only been highlighted in anecdotal case reports in the past and to a lesser degree in the safety documentation of remdesivir.

Keywords: acute liver failure (alf); covid-19; drug-induced liver injury (dili); hepatology; pulmonology; remdesivir.

Publication types

  • Case Reports