{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:04:55Z","timestamp":1777860295538,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JRS"],"published-print":{"date-parts":[[2023,5,4]]},"abstract":"<jats:p>BACKGROUND: Recently, antivirals, including remdesivir, have been repurposed to treat COVID-19 infections. Initial concerns have been raised about the adverse renal and cardiac events associated with remdesivir. OBJECTIVE: This study aimed to analyse the adverse renal and cardiac events associated with remdesivir in patients with COVID-19 infections using the US FDA adverse event reporting system. METHOD: A case\/non-case method was used to determine adverse drug events associated with remdesivir as the primary suspect drug between January 1, 2020, and November 11, 2021, for patients with COVID-19 infections. Cases were reports for remdesivir with \u22651 ADEs as preferred terms included in the Medical Dictionary of Regulatory Activities (MedDRA) system organ classes \u2018Renal and urinary disorders\u2019 or \u2018cardiac\u2019 disorders. To measure disproportionality in reporting of ADEs, frequentist approaches, including the proportional reporting ratio (PRR) and reporting odds ratio (ROR), were used. The empirical Bayesian Geometric Mean (EBGM) score and information component (IC) value were calculated using a Bayesian approach. A signal was defined as the lower limit of 95% confidence intervals of ROR \u2265 2, PRR \u2265 2, IC &gt; 0, and EBGM &gt; 1 for ADEs with \u22654 reports. Sensitivity analyses were undertaken by excluding reports for non-Covid indications and medications strongly associated with AKI and cardiac arrhythmias. RESULTS: In the main analysis for remdesivir use in patients with COVID-19 infections, we identified 315 adverse cardiac events comprising 31 different MeDRA PTs and 844 adverse renal events comprising 13 different MeDRA PTs. Regarding adverse renal events, disproportionality signals were noted for \u201crenal failure\u201d (ROR = 2.8 (2.03\u20133.86); EBGM = 1.92 (1.58\u20132.31), \u201cacute kidney injury\u201d (ROR = 16.11 (12.52\u201320.73); EBGM = 2.81 (2.57\u20133.07), \u201crenal impairment\u201d (ROR = 3.45 (2.68\u20134.45); EBGM = 2.02 (1.74\u20132.33). Regarding adverse cardiac events, strong disproportionality signals were noted for \u201celectrocardiogram QT prolonged\u201d (ROR = 6.45 (2.54\u201316.36); EBGM = 2.04 (1.65\u20132.51), \u201cpulseless electrical activity\u201d (ROR = 43.57 (13.64\u2013139.20); EBGM = 2.44 (1.74\u20133.33), \u201csinus bradycardia\u201d (ROR = 35.86 (11.16\u2013115.26); EBGM = 2.82 (2.23\u20133.53), \u201cventricular tachycardia\u201d (ROR = 8.73 (3.55\u201321.45); EBGM = 2.52 (1.89\u20133.31). The risk of AKI and cardiac arrythmias were confirmed by sensitivity analyses. CONCLUSION: This hypothesis-generating study identified AKI and cardiac arrhythmias associated with remdesivir use in patients with COVID-19 infections. The relationship between AKI and cardiac arrhythmias should be further investigated using registries or large clinical data to assess the impact of age, genetics, comorbidity, and the severity of Covid infections as potential confounders.<\/jats:p>","DOI":"10.3233\/jrs-220009","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T12:25:59Z","timestamp":1683289559000},"page":"87-99","source":"Crossref","is-referenced-by-count":2,"title":["Acute renal failure and cardiac arrhythmias associated with remdesivir use in patients with COVID-19 infections: Analysis using the US FDA adverse event reporting system"],"prefix":"10.1177","volume":"34","author":[{"given":"Lisajo","family":"Orogun","sequence":"first","affiliation":[{"name":", University of Bath, , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Te-yuan","family":"Chyou","sequence":"additional","affiliation":[{"name":", University of Otago, , New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prasad S.","family":"Nishtala","sequence":"additional","affiliation":[{"name":", Centre for Therapeutic Innovation, University of Bath, , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"issue":"1","key":"10.3233\/JRS-220009_ref4","doi-asserted-by":"crossref","first-page":"2856","DOI":"10.1080\/07853890.2022.2133162","article-title":"COVID-19 treatments approved in the European Union and clinical recommendations for the management of non-hospitalized and hospitalized patients","volume":"54","author":"Bellino","year":"2022","journal-title":"Ann Med"},{"issue":"1","key":"10.3233\/JRS-220009_ref5","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.ajt.2022.12.004","article-title":"Paxlovid associated with decreased hospitalization rate among adults with COVID-19 - United States, April\u2013September 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