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Case report
Use of remdesivir in the presence of elevated LFTs for the treatment of severe COVID-19 infection
  1. Andrew J Sabers1,
  2. Amber L Williams1 and
  3. T Michael Farley1,2
  1. 1Pharmacy Practice and Science, University of Iowa College of Pharmacy, Iowa City, Iowa, USA
  2. 2Pharmacy, Mercy Hospital Iowa City, Iowa City, Iowa, USA
  1. Correspondence to Dr T Michael Farley; mike-farley{at}


An 82-year-old man with an extensive medical history presented to the emergency room with complaints of generalised weakness and cough. He tested positive for COVID-19 10 days prior to presenting to the emergency room. Although his symptoms started a week prior to diagnosis, his weakness increased, warranting emergency response. A comprehensive metabolic panel was drawn from the patient on admission, indicating markedly high liver function tests (LFTs) ≥20 times above the upper limit of normal. On day 1 of admission, the decision was still made to start remdesivir (5-day course) due to decompensated acute respiratory failure as well as dexamethasone. The patient’s LFTs significantly improved throughout his hospital stay. The patient made a full recovery and was discharged on day 10 of hospitalisation.

  • infections
  • drugs: infectious diseases
  • adult intensive care

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  • Contributors All authors (ALW, AJS, TMF) contributed to the planning, chart review, acquisition of data, interpretation of data, and writing and approval of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.