Remdesivir use in pregnant women with severe COVID-19

Sarada Mamilla, Harikishan Boorugu, Ramya Bharghavi B. P. L., Bhavana Priya Kodam, Sandhya Rani Adapa, Gayathri Kamani, Tejaswi Vuta


Numerous therapeutic strategies are proposed and tested for SARS CO-V2 infection. Remdesivir is researched and proposed by various societies. Studies about efficacy and safety in pregnancy are limited. A case series of 22 pregnant women effected with severe COVID disease and who received remdesivir, over a period of 1 year from May 2020 to May 2021 is presented. The 12 antenatal and 10 post-partum women were included. Demographic factors, baseline, day 3 and day 7 blood values of haemoglobin, total leukocyte count, platelets, liver enzymes, serum creatinine and D-dimers were collected. Adverse events were reported. Pregnancy complications and foetal and neonatal complications were studied. Pre-eclampsia was the most common comorbidity. The 99% of pregnant women and 100% of postpartum women recovered from COVID disease after remdesivir use. Lab investigations did not change considerably during the week of remdesivir use, suggesting its safety. Incidence of adverse events reported is 36.3%, of these 9% are serious adverse events. There are no antenatal or post-natal complications. No incidence of teratogenicity, foetal or neonatal complications. Incidence of feto-maternal transmission was 9%. Remdesivir is effective in treating severe SARS-CoV2 infection and has safety profile in pregnancy with regard to maternal and foetal effects.


Remdesivir in pregnancy, Fetal effects of remdesivir, Neonatal side effects of remdesivir, Maternal safety with remdesivir

Full Text:



Lai CC, Chen CH, Wang CY, Chen KH, Wang YH, Hsueh PR. Clinical efficacy and safety of remdesivir in patients with COVID-19: a systematic review and network meta-analysis of randomized controlled trials. J Antimicrob Chemother. 2021;dkab093.

Siemieniuk R, Rochwerg B, Agoritsas T, Lamontagne F, Leo YS, Macdonald H et al. A living WHO guideline on drugs for COVID-19. Bri Med J. 2020;370:m3379.

Taylor MM, Kobeissi L, Kim C. Inclusion of pregnant women in COVID‐19 treatment trials: a review and global call to action. Lancet Glob Heal. 2020;9(3):e366‐71.

Society for Maternal-Fetal Medicine. Coronavirus (COVID-19) and Pregnancy: What Maternal Fetal Medicine Subspecialists Need to Know. 2020.

Royal College of Obstetricians and Gynaecologists. Coronavirus (COVID-19) infection and pregnancy, 2020. Available at: Accessed on 10 Jan, 2021.

Gandhi A, Ganatra A, Tank P. FOGSI GCPR on Pregnancy with COVID-19 infection Version 2. Federation of Obstetric and Gynaecological Societies of India. 2020. Accessed on 25 Jul, 2020.

Ministry of Health and Family Welfare, Government of India. Advisory for rational use of remdesivir for COVID-19 treatment. 2021.

Burwick RM, Yawetz S, Stephenson KE, Collier AR, Sen P, Blackburn BG et al. Compassionate use of remdesivir in pregnant women with severe coronavirus disease 2019. Clin Infect Dis. 2020;ciaa1466.

McCoy JA, Short WR, Srinivas SK, Levine LD, Hirshberg A. Compassionate use of remdesivir for treatment of severe coronavirus disease 2019 in pregnant women at a United States academic center. Am J Obstet Gynecol MFM. 2020;2(3):100164.

Igbinosa I, Miller S, Bianco K. Use of remdesivir for pregnant patients with severe novel coronavirus disease 2019. Am J Obstet Gynecol. 2020;223:768‐70.

Maldarelli GA, Savage M, Mazur S, Oxford‐Horrey C, Salvatore M, Marks KM. Remdesivir treatment for severe COVID‐19 in third‐ trimester pregnancy: case report and management discussion. Open Forum Infect Dis. 2020;7.

Jacobson J, Antony K, Beninati M, Alward W, Hoppe KK. Use of dexamethasone, remdesivir, convalescent plasma and prone positioning in the treatment of severe COVID‐19 infection in pregnancy: z case report. Case Reports Women's Heal. 2021;29.

Naqvi M, Zakowski P, Glucksman L, Smithson S, Burwick RM. Tocilizumab and remdesivir in a pregnant patient with coronavirus disease 2019 (COVID‐19). Obstet Gynecol. 2020;136:1025‐9.

Mulangu S, Dodd LE, Davey RT, et al. A randomized, controlled trial of ebola virus disease therapeutics. N Engl J Med. 2019;381:2293‐303.