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. 2022 May:118:247-253.
doi: 10.1016/j.ijid.2022.03.015. Epub 2022 Mar 14.

COVID-19 and kidney transplantation: the impact of remdesivir on renal function and outcome - a retrospective cohort study

Florin Elec  1 , Jesper Magnusson  2 , Alina Elec  3 , Adriana Muntean  3 , Oana Antal  4 , Tudor Moisoiu  5 , Cristina Cismaru  6 , Mihaela Lupse  6 , Mihai Oltean  7
Affiliations

COVID-19 and kidney transplantation: the impact of remdesivir on renal function and outcome - a retrospective cohort study

Florin Elec et al. Int J Infect Dis. 2022 May.

Abstract

Objectives: The aim of the study was to evaluate the impact of remdesivir on overall mortality, ICU mortality, and renal functional outcome in hospitalized patients with COVID-19 who received kidney transplant.

Methods: We reviewed 165 patients with KTx hospitalized owing to COVID-19 between March 1, 2020, and May 31, 2021. A total of 38 patients with KTx received a 5-day RDV treatment, whereas 127 received standard of care (SOC). Overall and ICU mortality along with functional outcome were assessed.

Results: The 2 groups had similar baseline characteristics. RDV treatment was completed in all patients without any adverse effects attributable to RDV. In terms of overall mortality, there was no difference between the RDV and SOC groups (18% vs 23%, p >0.05), but the ICU mortality was significantly reduced in the RDV group (39% vs 83%, p <0.05). RDV seems to have no nephrotoxic effect on patients with KTx because there was no difference in the incidence of AKI between RDV and SOC groups (50% vs 43%, p >0.05), and the discharge eGFR values significantly improved in the RDV group compared with the admission values (57 ± 23 vs 44 ± 22, p <0.05).

Conclusion: Five-day RDV treatment appears safe in KTx recipients, and without obvious nephrotoxic effects. Also, RDV may decrease ICU mortality attributed to COVID-19.

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Figures

FIGURE 1
Figure 1
A) Overall mortality of Remdesivir (RDV) and standard of care (SOC) groups. B) Kaplan–Meier overall survival analysis for RDV and SOC groups. C) Intensive care unit (ICU) mortality for RDV and SOC groups. D) Kaplan–Meier ICU survival for RDV and SOC groups.
FIGURE 2
Figure 2
A) COVID 19 severity for Remdesivir (RDV) and standard of care (SOC) groups. B) Violin plot with mean and standard deviation representation of discharge estimated glomerular filtration rate (eGFR) for RDV and SOC groups. C) Violin plot with mean and standard deviation representation of baseline and discharge eGFR for RDV group.
See this image and copyright information in PMC

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