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General Rehabilitation

Transient Dermatologic and Neuromuscular Complications Induced by Remdesivir in a COVID-19 Patient: A Case Study

Saturday, October 25, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 1

    Co-Author(s)

  • Bendik Stenersen, DO, MS

    Resident Physician
    Larkin Community Hospital PM&R Program
    Miami, Florida

    • Primary Author(s)

  • HT

    Hein Linn Thant, MD

    PGY3
    Larkin Community Hospital PM&R Program
    Pembroke Pines, Florida

    • Co-Author(s)

  • MG

    Marvin Guillen, MD

    RESIDENT PHYSICIAN
    Larkin Community Hospital - PM&R
    FORT LAUDERDALE, Florida

  • JS

    Jasmine Sidhu, MD

    PGY 4 PM&R Resident
    Larkin Community Hospital PM&R Program
    Miami, Florida

  • Anusha Pasupuleti, MD

    Resident physician
    Larkin Community Hospital PM&R program
    STERLING, Virginia

  • LT

    Lauren E. Taylor, Other

    Medical Student
    Nova Southeastern University Dr Kiran C Patel College of Osteopathic Medicine
    Delray Beach, Florida

    • Co-Author(s)

  • Camilo Osorio, MD

    Resident Physician Larkin Community Hospital PM&R Program
    Larkin Community Hospital

Disclosure(s):
Hein Linn Thant, MD: No financial relationships to disclose
Anusha Pasupuleti, MD: No financial relationships to disclose
Camilo Osorio, MD: No financial relationships to disclose
Case Diagnosis: This case presents a rare occurrence of transient cutaneous and neuromuscular complications following remdesivir administration, emphasizing the need for vigilant monitoring and individualized treatment strategies.

Case Description or Program Description: An 83-year-old male with multiple comorbidities was admitted for worsening cough and fever, tested positive for COVID-19, and began remdesivir. After two doses, he developed a facial rash, worsening right-sided weakness, and AKI. Remdesivir was discontinued, and supportive measures were implemented. Upon stabilization, he was transferred to an acute inpatient rehabilitation facility.
His facial rash improved within one week and resolved by discharge. His neuromuscular function progressively recovered:
Motor Examination
Admission: RUE: 4-/5, RLE: 3-/5
Seven Days: RUE: 5/5, RLE: 4-/5
Ten Days: Strength: 5/5 in all extremities

Setting: Acute inpatient rehabilitation

Assessment/Results: Patient developed transient facial rash and neuromuscular weakness, after short course remdesivir. fortunately had full recovery following discontinuation and rehabilitation.

Discussion (relevance): While remdesivir’s adverse effects primarily impact hepatic and renal function, dermatologic and neuromuscular complications remain rare. This case suggests a possible drug-induced reaction, as symptoms improved following remdesivir discontinuation and rehabilitation. Given that COVID-19 itself can cause myopathy, differentiating viral pathology from medication effects is challenging. Increased vigilance is needed to recognize these potential adverse effects.

Conclusions: This case highlights remdesivir’s potential for rare complications, including AKI, facial rash, and neuromuscular weakness. Its active metabolite may alter synaptic inhibition and disrupt the balance of excitatory and inhibitory signals. Close monitoring and multidisciplinary management are crucial to optimizing outcomes.