Abstract
Background: Remdesivir is not currently approved for patients with eGFR <30 ml/min per 1.73 m 2 . We aimed to determine the safety of remdesivir in patients with kidney failure.
Methods: This study was a retrospective cohort study of patients with COVID-19 hospitalized between May 2020 and January 2021 with eGFR <30 ml/min per 1.73 m 2 who received remdesivir and historical controls with COVID-19 hospitalized between March 1, 2020 and April 30, 2020 prior to the emergency use authorization of remdesivir within a large health care system. Patients were 1:1 matched by propensity scores accounting for factors associated with treatment assignment. Adverse events and hospital outcomes were recorded by manual chart review.
Results: The overall cohort included 34 hospitalized patients who initiated remdesivir within 72 hours of hospital admission with eGFR<30 ml/min per 1.73 m 2 and 217 COVID-19 controls with eGFR <30 ml/min per 1.73 m 2 . The propensity score-matched cohort included 31 remdesivir-treated patients and 31 nonremdesivir-treated controls. The mean age was 74.0 (SD=13.8) years, 57% were women, and 68% were white participants. A total of 26% had ESKD. Among patients who were not on dialysis prior to initiating remdesivir, one developed worsening kidney function (defined as ≥50% increase in creatinine or initiation of KRT) compared with three in the historical control group. There was no increased risk of cardiac arrythmia, cardiac arrest, altered mental status, or clinically significant anemia or liver function test abnormalities. There was a significantly increased risk of hyperglycemia, which may be partly explained by the increased use of dexamethasone in the remdesivir-treated population.
Conclusions: In this propensity score-matched study, remdesivir was well tolerated in patients with eGFR <30 ml/min per 1.73 m 2 .
Keywords: COVID-19; SARS-CoV-2; acute kidney injury; antiviral; chronic kidney disease; dialysis; propensity score; remdesivir.
【저자키워드】 COVID-19, SARS-CoV-2, Antiviral, Acute kidney injury, Chronic kidney disease, dialysis, remdesivir., Propensity score, 【초록키워드】 Dexamethasone, Treatment, Anemia, Health care, Hospitalized, Antiviral, Kidney function, hospital, Remdesivir, risk, Acute kidney injury, Chronic kidney disease, outcome, Emergency use authorization, dialysis, Cardiac arrest, kidney, adverse events, Cohort, Health, Patient, Control, Kidney disease, Liver function, age, Hospital admission, EGFR, women, hyperglycemia, Health care system, Care, Propensity score, creatinine, Kidney failure, Altered mental status, historical control, Liver function test, retrospective cohort study, Factor, Participants, Adverse, control group, increased risk, worsening, arrythmia, Abnormalities, propensity scores, controls, event, liver function test abnormalities, significantly increased, defined, clinically, approved, determine, explained, hospitalized patient, increase in, initiated, were recorded, 1:1, acute kidney, patients with COVID-19, with COVID-19, 【제목키워드】 with COVID-19,