COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to more than 50 million of infections and over 1 million deaths worldwide. Given the current, ongoing pandemic of COVID-19, there is a need to identify safe and effective treatment options among so many available   drugs. Remdesivir (GS-5734), a prodrug of adenosine analogues, has been shown to have antiviral activity against several RNA viruses, including MERS-CoV ,Ebola virus  and SARS-CoV-2..On May 1, 2020, after review of unpublished data from available clinical trials, the US Food and Drug Administration (US FDA) issued an emergency use authorization (EUA) to permit the use of remdesivir, a nucleotide analogue that inhibits viral RNA-dependent RNA polymerase (RDRP), for treatment of  severe coronavirus disease 2019 (COVID-19). Later on October 22, 2020, FDA approved its use in adults and pediatric patients (12 years of age and older and weighing at least 40 kg) for the treatment of COVID-19 requiring hospitalization. 1Notably, patients with severe AKI and ESKD were excluded from this and all other remdesivir trials on the basis of eGFR cut-offs (either 50 or 30 ml/min per 1.73m2).  Hence   it is not recommended in the group of patients where it required most just because of lack of data. But preliminary report suggests its use in these group of patients without its adverse effect on renal function.³. Based on these data it has been used in these group of patients in our hospital as well as all tertiary covid designated facilities after taking informed written consent from patients’ relative as there is no other suitable alternative exist. We want to analyse retrospectively its safety  in these patients.