Nagano Yasunori, Aoki Hisae, David Juri, Kondo Naoko Iwahashi, Aizawa Makimi, Sumita Toshiyuki, Hamada Yuki, Yamamoto Yuki, Yamada Kaoru
Department of Pharmacy, Sanraku Hospital, 2-5 Kandasurugadai, Chiyoda-ku, Tokyo, 1018326, Japan.
Department of Surgery, Sanraku Hospital, 2-5 Kandasurugadai, Chiyoda-ku, Tokyo, 1018326, Japan.
J Pharm Health Care Sci. 2025 Jan 27;11(1):5. doi: 10.1186/s40780-024-00406-1.
Remdesivir is recommended to treat hospitalized patients with coronavirus disease 2019 (COVID-19). Remdesivir is known to affect glucose metabolism in individuals with and without diabetes. However, little is known about the possibility of hypoglycemia associated with remdesivir. Our case is the first report demonstrating the development of severe hypoglycemia following remdesivir treatment in an elderly man without diabetes.
A 73-year-old man developed COVID-19 following surgery for sigmoid volvulus. The patient's medical history included surgery for posterior correction of scoliosis, Chiari malformation type I, and syringomyelia. There was no history of diabetes mellitus. The patient was started on remdesivir (200 mg on day 1, followed by 100 mg intravenously daily until day 9). On day 7, following remdesivir administration, the patient developed severe hypoglycemia with a blood glucose (BG) level of 25 mg/dL. On day 8 and 9 he repeatedly developed severe hypoglycemia following administration of remdesivir. Considering the timing of administration, the patient's hypoglycemia could have been caused by remdesivir. Therefore, his treatment with remdesivir was discontinued. After discontinuation, his BG levels normalized. The Naranjo algorithm, a tool for evaluating the causality of adverse drug reactions, classified the event as "Probable" (6 points).
Remdesivir may have caused hypoglycemia in this case. Health care professionals should be aware of its potential effects on glucose metabolism and the risk of hypoglycemia when treating patients with remdesivir.
瑞德西韦被推荐用于治疗2019冠状病毒病（COVID-19）住院患者。已知瑞德西韦会影响糖尿病患者和非糖尿病患者的葡萄糖代谢。然而，关于瑞德西韦相关低血糖的可能性知之甚少。我们的病例是首例报告，展示了一名无糖尿病的老年男性在接受瑞德西韦治疗后发生严重低血糖的情况。
一名73岁男性在乙状结肠扭转手术后感染了COVID-19。患者的病史包括脊柱侧弯后路矫正手术、I型Chiari畸形和脊髓空洞症。无糖尿病病史。患者开始接受瑞德西韦治疗（第1天200毫克，随后每天静脉注射100毫克直至第9天）。在第7天，给予瑞德西韦后，患者出现严重低血糖，血糖（BG）水平为25毫克/分升。在第8天和第9天，他在给予瑞德西韦后反复出现严重低血糖。考虑到给药时间，患者的低血糖可能是由瑞德西韦引起的。因此，停止了他的瑞德西韦治疗。停药后，他的血糖水平恢复正常。用于评估药物不良反应因果关系的Naranjo算法将该事件分类为“可能”（6分）。
在本病例中，瑞德西韦可能导致了低血糖。医护人员在使用瑞德西韦治疗患者时应意识到其对葡萄糖代谢的潜在影响以及低血糖风险。
