---
title: "Virologic findings from REDPINE: remdesivir activity and resistance in renally impaired and immuno"
id: "pubmed-42429789"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42429789"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42429789/"
doi: "10.1128/aac.01912-25"
published_at: "2026-08-05T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Virologic findings from REDPINE: remdesivir activity and resistance in renally impaired and immuno
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42429789
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42429789/)
- **DOI:** [10.1128/aac.01912-25](https://doi.org/10.1128%2Faac.01912-25)
- **Published At:** 2026-08-05T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The Phase 3 REDPINE trial evaluated **remdesivir** versus placebo in hospitalized adults with COVID-19 and impaired kidney function, with virologic analyses from nasopharyngeal swabs collected at baseline through Day 29. - A total of 243 participants were enrolled and treated; 42 participants had prior solid organ transplantation (SOT) and were receiving immunosuppressive therapy. - Virology assessments used **SARS-CoV-2 RT-qPCR**, next-generation sequencing (NGS), and site-directed mutagenesis in a SARS-CoV-2 replicon system to assess susceptibility and characterize substitutions. - Remdesivir produced significantly greater reductions in **viral load** from baseline on Day 5 and Day 7 versus placebo (P ≤ 0.034). - Among remdesivir-treated participants, those with SOT had significantly smaller viral load reductions from baseline on Days 5, 7, and 14 compared with non-SOT participants (all P 13-day faster time to viral load decline with the longer regimen. - In four remdesivir-treated participants, emergent substitutions in polymerase Nsp12 (E136V, M794I, C799F) were detected 9 days after stopping treatment; these substitutions conferred low-level reduced in vitro susceptibility to remdesivir (≤3.4-fold change in EC50) in replicon assays. Three of the four participants with emergent substitutions had SOT. - Overall, remdesivir showed antiviral activity in patients with impaired kidney function; delayed clearance and rare low-level emergent Nsp12 substitutions occurred more often in SOT recipients. - The trial is registered as ClinicalTrials.gov NCT04745351 and EudraCT 2020-005416-22. - Conflict of interest disclosures: multiple authors are employees and stockholders of Gilead Sciences; other authors reported research funding or advisory relationships with various companies as detailed in the source.
## Clinical Analysis & Structured Key Points
Clipboard, Search History, and several other advanced features are temporarily unavailable. [ Skip to main page content ](https://pubmed.ncbi.nlm.nih.gov/42429789/#article-details) ![U.S. flag](https://cdn.ncbi.nlm.nih.gov/coreutils/uswds/img/favicons/favicon-57.png) An official website of the United States government Here's how you know ![Dot gov](https://cdn.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-dot-gov.svg) **The .gov means it’s official.** Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site. ![Https](https://cdn.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-https.svg) **The site is secure.** The **https://** ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. [ ![NIH NLM Logo](https://cdn.ncbi.nlm.nih.gov/coreutils/nwds/img/logos/AgencyLogo.svg) ](https://www.ncbi.nlm.nih.gov/) [Log in](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42429789%2F) Show account info Close #### Account Logged in as: **username** * [Dashboard](https://www.ncbi.nlm.nih.gov/myncbi/) * [Publications](https://www.ncbi.nlm.nih.gov/myncbi/collections/bibliography/) * [Account settings](https://www.ncbi.nlm.nih.gov/account/settings/) * [Log out](https://www.ncbi.nlm.nih.gov/account/signout/?back_url=https%3A//pubmed.ncbi.nlm.nih.gov/42429789/) [Access keys](https://www.ncbi.nlm.nih.gov/guide/browsers/#ncbi_accesskeys) [NCBI Homepage](https://www.ncbi.nlm.nih.gov) [MyNCBI Homepage](https://pubmed.ncbi.nlm.nih.gov/myncbi/) [Main Content](https://pubmed.ncbi.nlm.nih.gov/42429789/#maincontent) [Main Navigation](https://pubmed.ncbi.nlm.nih.gov/42429789/) [ ![pubmed logo](https://cdn.ncbi.nlm.nih.gov/pubmed/af7de7da-df5d-41c6-8de4-8c266af8ccfb/core/images/pubmed-logo-blue.svg) ](https://pubmed.ncbi.nlm.nih.gov/) [ ](https://pubmed.ncbi.nlm.nih.gov/42429789/ "Show search bar") Search: [](https://pubmed.ncbi.nlm.nih.gov/42429789/ "Clear search input")Search [Advanced](https://pubmed.ncbi.nlm.nih.gov/advanced/) [ Clipboard ](https://pubmed.ncbi.nlm.nih.gov/clipboard/) [ User Guide ](https://pubmed.ncbi.nlm.nih.gov/help/) Save Email Send to * [ Clipboard ](https://pubmed.ncbi.nlm.nih.gov/42429789/) * [My Bibliography](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42429789%2F%23open-bibliography-panel) * [Collections](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42429789%2F%23open-collections-panel) * [Citation manager](https://pubmed.ncbi.nlm.nih.gov/42429789/) Display options Display options Format Abstract PubMed PMID ## Save citation to file Format: Summary (text) PubMed PMID Abstract (text) CSV Create file Cancel ## Email citation Email address has not been verified. Go to [ My NCBI account settings ](https://account.ncbi.nlm.nih.gov/settings/) to confirm your email and then refresh this page. To: Subject: Body: Format: Summary Summary (text) Abstract Abstract (text) MeSH and other data Send email Cancel ### Add to Collections * Create a new collection * Add to an existing collection Name your collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42429789/) Add Cancel ### Add to My Bibliography * My Bibliography Unable to load your delegates due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42429789/) Add Cancel ## Your saved search Name of saved search: Search terms: [Test search terms](https://pubmed.ncbi.nlm.nih.gov/42429789/) Would you like email updates of new search results? Saved Search Alert Radio Buttons * Yes * No Email: ([change](https://www.ncbi.nlm.nih.gov/account/settings/)) Frequency: Monthly Weekly Daily Which day? The first Sunday The first Monday The first Tuesday The first Wednesday The first Thursday The first Friday The first Saturday The first day The first weekday Which day? Sunday Monday Tuesday Wednesday Thursday Friday Saturday Report format: Summary Summary (text) Abstract Abstract (text) PubMed Send at most: 1 item 5 items 10 items 20 items 50 items 100 items 200 items Send even when there aren't any new results Optional text in email: Save Cancel ## Create a file for external citation management software Create file Cancel ## Your RSS Feed Name of RSS Feed: Number of items displayed: 5 10 15 20 50 100 Create RSS Cancel RSS Link Copy ### Full text links [![Atypon full text link](https://cdn.ncbi.nlm.nih.gov/corehtml/query/egifs/https:--journals.asm.org-pb-assets-pubmed-pubmed_AAC.png) Atypon ](https://journals.asm.org/doi/10.1128/aac.01912-25?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed "See full text options at Atypon") [ Full text links ](https://pubmed.ncbi.nlm.nih.gov/42429789/) ### Actions Cite Collections Add to Collections * Create a new collection * Add to an existing collection Name your collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error [Please try again](https://pubmed.ncbi.nlm.nih.gov/42429789/) Add Cancel Permalink Permalink Copy Display options Display options Format Abstract PubMed PMID ### Page navigation * [ Title & authors ](https://pubmed.ncbi.nlm.nih.gov/42429789/#heading) * [ Abstract ](https://pubmed.ncbi.nlm.nih.gov/42429789/#abstract) * [ Conflict of interest statement ](https://pubmed.ncbi.nlm.nih.gov/42429789/#conflict-of-interest) * [Similar articles](https://pubmed.ncbi.nlm.nih.gov/42429789/#similar) * [ Publication types ](https://pubmed.ncbi.nlm.nih.gov/42429789/#publication-types) * [ MeSH terms ](https://pubmed.ncbi.nlm.nih.gov/42429789/#mesh-terms) * [ Substances ](https://pubmed.ncbi.nlm.nih.gov/42429789/#substances) * [ Associated data ](https://pubmed.ncbi.nlm.nih.gov/42429789/#supplemental-data) * [Related information](https://pubmed.ncbi.nlm.nih.gov/42429789/#related-links) * [ Grants and funding ](https://pubmed.ncbi.nlm.nih.gov/42429789/#grants) * [ LinkOut - more resources ](https://pubmed.ncbi.nlm.nih.gov/42429789/#linkout) Title & authors Abstract Conflict of interest statement Similar articles Publication types MeSH terms Substances Associated data Related information Grants and funding LinkOut - more resources Clinical Trial Antimicrob Agents Chemother Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Antimicrob+Agents+Chemother%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Antimicrob+Agents+Chemother%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42429789/) . 2026 Aug 5;70(8):e0191225. doi: 10.1128/aac.01912-25. Epub 2026 Jul 10. # Virologic insights from the phase 3 REDPINE trial: remdesivir in renally impaired and immunocompromised patients with COVID-19 [Lauren Rodriguez](https://pubmed.ncbi.nlm.nih.gov/?term=Rodriguez+L&cauthor_id=42429789)[#](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Kristen Andreatta](https://pubmed.ncbi.nlm.nih.gov/?term=Andreatta+K&cauthor_id=42429789)[#](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Shuguang Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+S&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Yu Hu](https://pubmed.ncbi.nlm.nih.gov/?term=Hu+Y&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Jiani Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+J&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Ross Martin](https://pubmed.ncbi.nlm.nih.gov/?term=Martin+R&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Dong Han](https://pubmed.ncbi.nlm.nih.gov/?term=Han+D&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Jasmine Moshiri](https://pubmed.ncbi.nlm.nih.gov/?term=Moshiri+J&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Jason K Perry](https://pubmed.ncbi.nlm.nih.gov/?term=Perry+JK&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Meghan E Sise](https://pubmed.ncbi.nlm.nih.gov/?term=Sise+ME&cauthor_id=42429789)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-2 "Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA."), [Jose Ramon Santos](https://pubmed.ncbi.nlm.nih.gov/?term=Santos+JR&cauthor_id=42429789)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-3 "Fight Infections Foundation, Service of Infectious Diseases, Hospital Universitari Germans Trias i Pujol, Badalona, Spain."), [Markus Plate](https://pubmed.ncbi.nlm.nih.gov/?term=Plate+M&cauthor_id=42429789)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-4 "Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA."), [Mark J McPhail](https://pubmed.ncbi.nlm.nih.gov/?term=McPhail+MJ&cauthor_id=42429789)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-5 "Institute of Liver Studies, King's College Hospital, London, United Kingdom."), [Yiannis Koullias](https://pubmed.ncbi.nlm.nih.gov/?term=Koullias+Y&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Robert H Hyland](https://pubmed.ncbi.nlm.nih.gov/?term=Hyland+RH&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Charlotte Hedskog](https://pubmed.ncbi.nlm.nih.gov/?term=Hedskog+C&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#full-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA.") Affiliations Expand ### Affiliations * 1 Gilead Sciences, Inc., Foster City, California, USA. * 2 Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA. * 3 Fight Infections Foundation, Service of Infectious Diseases, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. * 4 Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA. * 5 Institute of Liver Studies, King's College Hospital, London, United Kingdom. # Contributed equally. * PMID: **42429789** * DOI: [ 10.1128/aac.01912-25 ](https://doi.org/10.1128/aac.01912-25) Item in Clipboard Clinical Trial # Virologic insights from the phase 3 REDPINE trial: remdesivir in renally impaired and immunocompromised patients with COVID-19 Lauren Rodriguez et al. Antimicrob Agents Chemother. 2026. Show details Display options Display options Format Abstract PubMed PMID Antimicrob Agents Chemother Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Antimicrob+Agents+Chemother%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Antimicrob+Agents+Chemother%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42429789/) . 2026 Aug 5;70(8):e0191225. doi: 10.1128/aac.01912-25. Epub 2026 Jul 10. ### Authors [Lauren Rodriguez](https://pubmed.ncbi.nlm.nih.gov/?term=Rodriguez+L&cauthor_id=42429789)[#](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Kristen Andreatta](https://pubmed.ncbi.nlm.nih.gov/?term=Andreatta+K&cauthor_id=42429789)[#](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Shuguang Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+S&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Yu Hu](https://pubmed.ncbi.nlm.nih.gov/?term=Hu+Y&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Jiani Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+J&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Ross Martin](https://pubmed.ncbi.nlm.nih.gov/?term=Martin+R&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Dong Han](https://pubmed.ncbi.nlm.nih.gov/?term=Han+D&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Jasmine Moshiri](https://pubmed.ncbi.nlm.nih.gov/?term=Moshiri+J&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Jason K Perry](https://pubmed.ncbi.nlm.nih.gov/?term=Perry+JK&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Meghan E Sise](https://pubmed.ncbi.nlm.nih.gov/?term=Sise+ME&cauthor_id=42429789)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-2 "Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA."), [Jose Ramon Santos](https://pubmed.ncbi.nlm.nih.gov/?term=Santos+JR&cauthor_id=42429789)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-3 "Fight Infections Foundation, Service of Infectious Diseases, Hospital Universitari Germans Trias i Pujol, Badalona, Spain."), [Markus Plate](https://pubmed.ncbi.nlm.nih.gov/?term=Plate+M&cauthor_id=42429789)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-4 "Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA."), [Mark J McPhail](https://pubmed.ncbi.nlm.nih.gov/?term=McPhail+MJ&cauthor_id=42429789)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-5 "Institute of Liver Studies, King's College Hospital, London, United Kingdom."), [Yiannis Koullias](https://pubmed.ncbi.nlm.nih.gov/?term=Koullias+Y&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Robert H Hyland](https://pubmed.ncbi.nlm.nih.gov/?term=Hyland+RH&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA."), [Charlotte Hedskog](https://pubmed.ncbi.nlm.nih.gov/?term=Hedskog+C&cauthor_id=42429789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42429789/#short-view-affiliation-1 "Gilead Sciences, Inc., Foster City, California, USA.") ### Affiliations * 1 Gilead Sciences, Inc., Foster City, California, USA. * 2 Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA. * 3 Fight Infections Foundation, Service of Infectious Diseases, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. * 4 Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA. * 5 Institute of Liver Studies, King's College Hospital, London, United Kingdom. # Contributed equally. * PMID: **42429789** * DOI: [ 10.1128/aac.01912-25 ](https://doi.org/10.1128/aac.01912-25) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract Remdesivir inhibits the SARS-CoV-2 RNA-dependent polymerase (Nsp12). Here, we present virology analyses from the Phase 3 REDPINE trial in participants with impaired kidney function hospitalized for COVID-19 and treated with remdesivir or placebo for 5 days. Out of 243 participants enrolled and treated in the study, 42 participants had solid organ transplantation (SOT) and received immunosuppressive medication prior to and during the study. Nasopharyngeal swabs were collected at baseline and through Day 29. Virology assessments were performed using SARS-CoV-2 RT-qPCR, next-generation sequencing, and site-directed mutagenesis in a SARS-CoV-2 replicon system. Remdesivir treatment demonstrated significantly greater reductions from baseline in viral load on Day 5 and Day 7 compared with placebo (_P_ ≤ 0.034). In the remdesivir treatment group, participants with SOT showed significantly smaller viral load reductions from baseline on Days 5, 7, and 14 compared with participants without SOT (all _P_ 13-day faster time to viral load decline by extending the remdesivir treatment duration from 5 days to 10 days. In four participants treated with remdesivir, emergent substitutions in Nsp12 (E136V, M794I, and C799F) with low-level reduced _in vitro_ susceptibility to remdesivir (≤3.4 fold change in half-maximal effective concentration) were observed 9 days after cessation of remdesivir treatment. Three of the four participants had undergone SOT. Overall, remdesivir demonstrated antiviral activity in participants with impaired kidney function, with delayed viral clearance in SOT recipients and rare posttreatment emergence of Nsp12 substitutions that confer low-level reduced susceptibility to remdesivir.CLINICAL TRIALSThis study is registered with ClinicalTrials.gov as [NCT04745351](http://clinicaltrials.gov/show/NCT04745351 "See in ClinicalTrials.gov"); EudraCT registration no. 2020-005416-22. **Keywords:** COVID-19; SARS-CoV-2; remdesivir; viral shedding; virologic resistance. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement L.R., K.A., S.C., J.L., R.M., D.H., J.M., J.K.P., Y.K., R.H.H., and C.H. are employees and stockholders of Gilead Sciences, Inc. Y.H. is a stockholder and former employee of Gilead Sciences, Inc. M.E.S. received research funding from Amgen, AstraZeneca, Cabaletta, Gilead Sciences, Inc., Merck, Novartis, Otsuka, and Roche/Genentech; served on scientific advisory boards or had scientific consulting agreements with Biogen, Medibeacon, Merida Biosciences, Novartis, Otsuka, Relay TX, Travere, and Vera; and is a data safety monitoring committee member for Alpine Immune Sciences/Vertex. J.R.S. received research funding, consulting fees, and lecture sponsorships from and served on advisory boards for Gilead Sciences, Inc., GSK, Janssen-Cilag, Bristol Myers Squibb, ViiV Healthcare, and Merck Sharp & Dohme. The other authors have no disclosures to report. ## Similar articles * [ No Remdesivir Resistance Observed in the Phase 3 Severe and Moderate COVID-19 SIMPLE Tr
## Related Clinical Research

- [Ebola Preparedness: Addressing the Gap in Virus Species Research](https://medichelpline.com/clinical-feed/stat-news-9-opinion-we-prepared-for-ebola-but-not-this-ebola.md)
- [Bundibugyo Ebola outbreak reveals gaps in Ebola preparedness and need for pan-filovirus tools](https://medichelpline.com/clinical-feed/stat-news-1-opinion-we-prepared-for-ebola-but-not-this-ebola.md)
- [Phase 1 trials and PARTNERS platform target Bundibugyo Ebola strain](https://medichelpline.com/clinical-feed/medical-news-today-40-phase-1-trials-for-ebola-treatments-and-vaccines-offer-hope-say-experts.md)
- [Feasibility Study of IV Remdesivir for Long COVID: ERASE LC Trial Results](https://medichelpline.com/clinical-feed/medrxiv-3-an-open-label-feasibility-study-of-remdesivir-in-long-covid-results-from-the.md)
- [Bundibugyo virus infection treated with MBP134 monoclonal antibodies and remdesivir: a case report](https://medichelpline.com/clinical-feed/nature-0-a-case-of-bundibugyo-virus-disease-treated-with-monoclonal-antibodies-and.md)

## Navigation
- [← Back to Infectious Disease Feed](https://medichelpline.com/clinical-feed/infectious-disease.md)
- [← All Clinical Specialties](https://medichelpline.com/clinical-feed.md)
## Medical & Regulatory Disclaimer

> [!CAUTION]
> MedicHelpline content is structured for research, educational, and professional discovery purposes. It does not constitute individual medical advice, clinical diagnosis, or treatment recommendations.
> Always verify dosing, contraindications, and regulatory alerts against official product labeling and primary regulatory sources before clinical decision-making.