- physician makes a decision that trial involvement is not in patients' best interest, or any condition that does not allow the protocol to be followed safely. - severe liver disease (alanine transaminase (alt) or aspartate transaminase (ast) > 5 times the upper limit of normal) - estimated glomerular filtration rate (egfr) < 30 ml/min (including patients receiving hemodialysis or hemofiltration). - mechanically ventilated (including v-v ecmo) ≥ 5 days, or any duration of v-a ecmo. - known hypersensitivity to the remdesivir, the metabolites, or formulation excipient - pregnancy or breast feeding. - anticipated discharge from the hospital or transfer to another hospital which is not a study site within 72 hours.

- physician makes a decision that trial involvement is not in patients' best interest, or any condition that does not allow the protocol to be followed safely. - severe liver disease (alanine transaminase (alt) or aspartate transaminase (ast) > 5 times the upper limit of normal) - estimated glomerular filtration rate (egfr) < 30 ml/min (including patients receiving hemodialysis or hemofiltration). - mechanically ventilated (including v-v ecmo) ≥ 5 days, or any duration of v-a ecmo. - known hypersensitivity to the remdesivir, the metabolites, or formulation excipient - pregnancy or breast feeding. - anticipated discharge from the hospital or transfer to another hospital which is not a study site within 72 hours.