Remdesivir lowers risks in patients on hemodialysis hospitalized with COVID-19
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Remdesivir treatment reduced risks for mortality, high-flow nasal cannula use and transfer to the ICU among patients on hemodialysis hospitalized with COVID-19, according to a study in Kidney International Reports.
Further, no significant adverse outcomes occurred in those who received remdesivir, according to researchers.
“Remdesivir has been widely used for COVID-19 treatment since it has received an Emergency Use Authorization by the U.S. Food and Drug Administration in May 2020,” Jeong-Hoon Lim, MD, PhD, from the division of nephrology at Kyungpook National University in Daegu, South Korea, and colleagues wrote. “Nevertheless, the clinical trials that evaluated the effect of remdesivir did not include patients with an estimated glomerular filtration rate < 30 mL/min/1.73 m2; therefore, the safety and clinical effectiveness of remdesivir remain to be confirmed in patients with end-stage kidney disease.”
In a retrospective cohort study, Lim and colleagues studied 118 patients who were hospitalized with COVID-19 and on hemodialysis to observe if remdesivir was clinically effective and safe in this patient population.
Data were obtained in the Kyungpook National University Chilgok Hospital between Jan. 26, 2022, and March 31, 2022, which, according to researchers, is when omicron was the main COVID-19 variant in South Korea.
In-hospital mortality, use of a high-flow nasal cannula (HFNC) and transfer to the ICU were the composite primary outcomes observed by researchers.
Additionally, researchers tracked disease severity and changes in the National Early Warning Score (NEWS). According to researchers, NEWS is made up of seven factors: respiratory rate, peripheral oxygen saturation, supplemental oxygen use, body temperature, systolic blood pressure, heart rate and neurologic status.
Of the total cohort, 44 (37.3%) received remdesivir. Researchers observed that compared with the non-remdesivir group, patients administered remdesivir had fewer experiences of the composite outcome of mortality, HFNC use and transfer to the ICU (10 [13.5%] vs. 1 [2.3%]). Patients in the remdesivir group also had a decreased disease severity aggravation rate compared with those who did not receive remdesivir (3 [6.8%] vs. 15 [20.3%]).
Researchers also found that despite a higher NEWS when they were hospitalized, the remdesivir group’s score significantly decreased as time passed in the hospital while NEWS increased in the non-remdesivir group.
Serious side effects, including liver function test derangement, hepatic failure, anaphylaxis reactions and hypersensitivity reactions, were not found in the remdesivir group.
“The use of remdesivir in patients with COVID-19 who are on hemodialysis improved the NEWS during hospitalization and prevented progression to severe or critical disease,” Lim and colleagues wrote. “Moreover, the risk [for] side effects of remdesivir was not high; thus, it could be used as an additional treatment option based on the benefits and risks to patients. Further large-scale randomized controlled trials for patients with COVID-19 who are on hemodialysis are needed to corroborate the findings of this study.”
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