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Remdesivir in COVID-19: pros and cons
Yara Rouhana El Feghali1, Layan Rabih1, Jad Abdul Khalek1
1Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Frontiers in Pharmacology
|March 2, 2026
Summary
Remdesivir (an antiviral) shortens recovery time and reduces mortality in COVID-19 patients, especially early in infection. Its use is now approved regardless of renal function, though its effects in congenital heart disease patients require further study.
Area of Science:
- Infectious Diseases
- Pharmacology
- Critical Care Medicine
Background:
- The COVID-19 pandemic necessitated rapid development of therapeutic agents.
- Remdesivir, initially developed for Ebola, showed broad-spectrum antiviral activity against coronaviruses.
- Remdesivir received FDA Emergency Use Authorization and full approval for treating severe COVID-19.
Purpose of the Study:
- To evaluate the benefits and drawbacks of remdesivir for COVID-19 treatment.
- To analyze remdesivir's efficacy in patients with congenital heart disease (CHD).
Main Methods:
- A literature review was conducted using PubMed and Google Scholar.
- The review focused on clinical trials and relevant reviews up to September 2025.
- Evidence from clinical trials was used to assess remdesivir's advantages and limitations.
Main Results:
- Remdesivir demonstrated a reduction in recovery time and mortality risk, particularly in early-stage or mild COVID-19.
- Safety studies confirmed remdesivir's use in patients with renal impairment, leading to an updated FDA label.
- While some studies showed limited effects, the overall evidence supports remdesivir's positive impact on COVID-19 clinical outcomes.
Conclusions:
- Remdesivir is a valuable therapeutic agent for improving COVID-19 outcomes.
- Further research is needed to understand remdesivir's effects in patients with congenital heart disease (CHD).
- Treatment strategies for COVID-19 in CHD patients require refinement in line with NIH guidelines.
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