# Remdesivir in COVID‐19: A Focus on Pediatric Cardiac Patients

**Authors:** Dima Bsat, Dalia Safi, Mariam Arabi

PMC · DOI: 10.1155/cjid/4700812 · The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien des Maladies Infectieuses et de la Microbiologie Médicale · 2026-02-24

## TL;DR

This paper reviews the use of remdesivir in treating COVID-19, focusing on its effectiveness in pediatric patients with heart conditions.

## Contribution

The paper emphasizes the lack of research on remdesivir's effects in pediatric cardiac patients and highlights the need for targeted studies.

## Key findings

- Most remdesivir studies focus on adults, leaving pediatric cardiac patients under-researched.
- Results from remdesivir trials are inconsistent, with some showing efficacy and others not.
- The paper identifies a need for age- and comorbidity-specific studies to improve treatment for high-risk patients.

## Abstract

The coronavirus disease 2019 (COVID‐19) pandemic has presented a significant global health challenge that necessitated the immediate search for various therapeutic modalities. Remdesivir, an antiviral drug inhibiting RNA‐dependent RNA polymerase (RdRp), was among the most heavily used drugs against COVID‐19. Of the several randomized controlled trials studying the efficacy of remdesivir, the vast majority were studied on the adult population. Results remain contradictory, with some studies supporting the high efficacy of remdesivir while others highlighting the lack of significance of its antiviral effects. Given the lack of focus on the pediatric population, the antiviral effects of remdesivir in cardiac pediatric patients, who are particularly vulnerable, remain especially under‐investigated. This literature review explores current literature on remdesivir’s mechanism of action and efficacy against COVID‐19, especially in the pediatric cardiac population. Therefore, by combining results of studies from randomized controlled trials and retrospective studies in the adult and pediatric populations, this literature review underlines current knowledge gaps and highlights the need for studies targeting specific ages and comorbidities to effectively treat patients at higher risk of adverse events.

## Linked entities

- **Proteins:** RNA-dependent RNA polymerase (RNA-dependent RNA polymerase), RdRP (RNA-directed RNA polymerase)
- **Chemicals:** remdesivir (PubChem CID 121304016)
- **Diseases:** coronavirus disease 2019 (MONDO:0100096), COVID-19 (MONDO:0100096)

## Full-text entities

- **Genes:** ORF1ab (ORF1a polyprotein;ORF1ab polyprotein) [NCBI Gene 43740578]
- **Diseases:** seizure disorders (MESH:D004827), MIS-C (MESH:C000705967), anemia (MESH:D000740), arm tremors (MESH:D014202), viral illnesses (MESH:D014777), hypertension (MESH:D006973), hematologic and neurologic conditions (MESH:D006402), death (MESH:D003643), neutropenia (MESH:D009503), thrombocytopenia (MESH:D013921), atrial fibrillation (MESH:D001281), 2019-nCoV (MESH:D000086382), immune dysfunction (MESH:D007154), post-infectious inflammatory illness (MESH:D000094025), ischemic injury (MESH:D017202), acute myocardial infarction (MESH:D009203), infection (MESH:D007239), cardiac adverse events (MESH:D002318), CHD (MESH:D006330), conduction abnormalities (MESH:D054537), cough (MESH:D003371), cardiac side effects (MESH:D064420), heart failure (MESH:D006333), impaired kidney function (MESH:D007674), fragmentation (MESH:D012892), prematurity (MESH:C536271), cardiac diseases (MESH:D006331), Constipation (MESH:D003248), hypokalemia (MESH:D007008), drug-induced liver injury (MESH:D056486), QT prolongation (MESH:D008133), septic shock (MESH:D012772), cardiac abnormalities (MESH:D018376), ill (MESH:D002908), sinus bradycardia (MESH:D012804), critically ill (MESH:D016638), shock (MESH:D012769), liver disease (MESH:D008107), headache (MESH:D006261), inflammation (MESH:D007249), mitochondrial (MESH:D028361), flu (MESH:D007251), lung fibrotic abnormalities (MESH:D008171), cancer (MESH:D009369), cardiogenic shock (MESH:D012770), asthma (MESH:D001249), neuroinflammation (MESH:D000090862), cardiac arrest (MESH:D006323), acute lung injury (MESH:D055371), abdominal pain (MESH:D015746), multiple-organ dysfunction (MESH:D009102), arrhythmias (MESH:D001145), nausea (MESH:D009325), obesity (MESH:D009765), hypoxic (MESH:D002534), tachyarrhythmias (MESH:D013610), acute respiratory failure (MESH:D012131), hypoalbuminemia (MESH:D034141), AKI (MESH:D058186), diarrhea (MESH:D003967)
- **Chemicals:** NTP (-), imdevimab (MESH:C000711488), dexamethasone (MESH:D003907), lopinavir/ritonavir (MESH:C558899), r (MESH:D001120), nucleoside (MESH:D009705), bamlanivimab (MESH:C000711749), heparins (MESH:D006493), GS-441524 (MESH:C000710751), adenosine (MESH:D000241), oxygen (MESH:D010100), tocilizumab (MESH:C502936), GS-704277 (MESH:C000722731), lactate (MESH:D019344), bilirubin (MESH:D001663), alanine (MESH:D000409), GS-5734 (MESH:C000606551), casirivimab (MESH:C000711487)
- **Species:** Homo sapiens (human, species) [taxon 9606], Coronaviridae (family) [taxon 11118], Ebola virus (no rank) [taxon 1570291], Severe acute respiratory syndrome coronavirus 2 (no rank) [taxon 2697049]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12931149/full.md

## References

62 references — full list in the complete paper: https://tomesphere.com/paper/PMC12931149/full.md

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Source: https://tomesphere.com/paper/PMC12931149