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This retrospective cohort study investigated whether remdesivir given during acute COVID-19 is associated with reduced incidence of Long COVID, including in immunocompromised subgroups. The HealthVerity database of hospital chargemaster data linked to closed claims was queried for patients aged\u2009\u2265\u200912\u00a0years hospitalized for\u2009\u2265\u20092\u00a0days with COVID-19 between May 1, 2020, and September 30, 2021. Relative risk between remdesivir-exposed and unexposed patients was calculated for 16 individual Long COVID outcomes and a composite of any Long COVID outcome, occurring 90\u2013270\u00a0days after hospital admission. Subgroup analyses occurred in immunocompromised patients. Regression models accounted for censoring, competing risks, and treatment assignment weights; statistical inferences were adjusted for multiple comparisons. Among 3,661,303 hospitalized patients, 52,006 with COVID-19 were included; 20,246 (38.9%) were immunocompromised. In the overall and immunocompromised populations, respectively, 33.0% and 29.5% received remdesivir; the composite of\u2009\u2265\u20091 Long COVID outcome occurred in 55.5% and 62.9%. Patients administered remdesivir experienced lower risk of any Long COVID outcome (risk ratio, 0.96; 95% CI 0.94\u20130.97; adjusted <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Risk for several individual Long COVID outcomes was lower in those receiving remdesivir in the overall and immunocompromised populations. In conclusion, exposure to remdesivir was associated with a lower risk of Long COVID.<\/jats:p>","DOI":"10.1038\/s41598-025-06052-3","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T12:43:19Z","timestamp":1753706599000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk of Long COVID in hospitalized individuals treated with remdesivir for acute COVID-19"],"prefix":"10.1038","volume":"15","author":[{"given":"Mark","family":"Berry","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda M.","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Paredes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Paone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Essy","family":"Mozaffari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikisha","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Gottlieb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lourdes","family":"Mateu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazin","family":"Abdelghany","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason D.","family":"Goldman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand P.","family":"Chokkalingam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"6052_CR1","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1038\/s41579-022-00846-2","volume":"21","author":"HE Davis","year":"2023","unstructured":"Davis, H. 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R.L.G. reports grants or contracts to his institution from Eli Lilly, Gilead Sciences, Inc., Johnson & Johnson, Pfizer, and Roivant Sciences (Kinevant Sciences); participation on advisory boards for and consulting fees from AbbVie, Eli Lilly, Gilead Sciences, Inc., G.S.K., and Roche; participation on an advisory board for AstraZeneca; payment or honoraria for lectures from Gilead Sciences, Inc. and a speaker bureau from Pfizer (the latter unrelated to infectious diseases); travel support from Gilead Sciences, Inc.; de minimis stockholder at AbCellera; and a gift-in-kind to his institution from Gilead Sciences, Inc. to facilitate an unrelated academic-sponsored clinical trial (ClinicalTrials.gov Identifier: NCT03383419). L.M. reports receiving grants from Grifols; receiving honoraria as a speaker from AstraZeneca, Gilead Sciences, Inc., G.S.K., Shionogi, and Pfizer; and participation in advisory boards for Gilead Sciences, Inc. and Merck. J.D.G. reports contracted research from Gilead Sciences, Inc. and Helix; grants from Gilead Sciences, Inc.; and serving as a speaker or advisory board member for Gilead Sciences, Inc., Merck, and Invivyd. A.M.K., J.P., R.S., and R.T. were employees of Aetion, Inc., at the time of the study. M.B., E.M., R.G., M.A., and A.P.C. were employees and stockholders of Gilead Sciences, Inc., at the time of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"27441"}}