Anaphylaxis and Severe Disseminated Intravascular Coagulation Due to Remdesivir

Intern Med. 2024 Mar 15;63(6):873-876. doi: 10.2169/internalmedicine.2994-23. Epub 2024 Jan 13.

Abstract

A 69-year-old woman suffering with multiple myeloma developed coronavirus disease 2019 (COVID-19). Shortly after administration of remdesivir, she presented with symptoms of facial flushing, wheezing, and hypoxemia. Subsequently, thrombocytopenia and hypofibrinogenemia rapidly manifested, leading to a diagnosis of enhanced fibrinolytic-type disseminated intravascular coagulopathy (DIC). This clinical presentation was considered an immediate hypersensitivity reaction with associated coagulation abnormalities induced by remdesivir. Although remdesivir is generally considered safe and efficacious in the treatment of COVID-19, physicians should remain vigilant regarding the potential for severe adverse events associated with this medication.

Keywords: COVID-19; DIC; anaphylaxis; remdesivir.

Publication types

  • Case Reports

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives*
  • Aged
  • Alanine / analogs & derivatives*
  • Anaphylaxis* / chemically induced
  • Anaphylaxis* / complications
  • Blood Coagulation Disorders*
  • COVID-19* / complications
  • Disseminated Intravascular Coagulation* / chemically induced
  • Disseminated Intravascular Coagulation* / complications
  • Female
  • Humans

Substances

  • remdesivir
  • Adenosine Monophosphate
  • Alanine