Effect of remdesivir on adverse kidney outcomes in hospitalized patients with COVID-19 and impaired kidney function.
<h4>Background</h4>Chronic kidney disease (CKD) is an important risk factor for mortality from COVID-19. Remdesivir has been shown to shorten time to recovery in patients with severe COVID-19. However, exclusion of patients with severe kidney function impairment in clinical trials has le...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0279765 |
| _version_ | 1827999741145776128 |
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| author | Rituvanthikaa Seethapathy Qiyu Wang Sophia Zhao Ian A Strohbehn Joshua D Long James E Dinulos Destiny Harden Vinay B Kadiyala Daiana Moreno Meghan E Sise |
| author_facet | Rituvanthikaa Seethapathy Qiyu Wang Sophia Zhao Ian A Strohbehn Joshua D Long James E Dinulos Destiny Harden Vinay B Kadiyala Daiana Moreno Meghan E Sise |
| author_sort | Rituvanthikaa Seethapathy |
| collection | DOAJ |
| description | <h4>Background</h4>Chronic kidney disease (CKD) is an important risk factor for mortality from COVID-19. Remdesivir has been shown to shorten time to recovery in patients with severe COVID-19. However, exclusion of patients with severe kidney function impairment in clinical trials has led to concerns about kidney safety of remdesivir in patients with pre-existing kidney disease.<h4>Methods</h4>Retrospective propensity score matched cohort study of hospitalized patients with COVID-19 admitted with estimated glomerular filtration rate (eGFR) between 15 - 60 mL/min/1.73m2. Remdesivir-treated patients were 1:1 matched to historical comparators admitted during the first wave of COVID-19 (between March-April 2020) prior to emergency use authorization of remdesivir using propensity scores accounting for factors predicting treatment assignment. Dependent outcomes included in-hospital peak creatinine, incidence of doubling of creatine, rate of kidney replacement therapy initiation and eGFR among surviving patients at day 90.<h4>Results</h4>175 remdesivir-treated patients were 1:1 matched to untreated historical comparators. Mean age was 74.1 (SD 12.8), 56.9% were male, 59% patients were white, and the majority (83.1%) had at least one co-morbidity. There were no statistically significant differences in peak creatinine during hospitalization (2.3mg/dL vs. 2.5 mg/dL, P = 0.34), incidence of doubling of creatinine (10.3% vs. 13.1%, P = 0.48), and rate of kidney replacement therapy initiation (4.6% vs. 6.3%, P = 0.49) in remdesivir-treated patients versus matched untreated historical comparators, respectively. Among surviving patients, there was no difference of the average eGFR at day 90 (54.7 ± 20.0 mL/min/1.73m2 for remdesivir-treated patients vs. 51.7 ± 19.5 mL/min/1.73m2 for untreated comparators, P = 0.41).<h4>Conclusions</h4>Remdesivir use in patients with impaired kidney function (eGFR between 15 - 60 mL/min/1.73m2) who present to the hospital with COVID-19 is not associated with increased risk of adverse kidney outcomes. |
| first_indexed | 2024-04-10T06:04:23Z |
| format | Article |
| id | doaj.art-e2b94e77a15748b9b09c88bdf19de5ef |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-10T06:04:23Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-e2b94e77a15748b9b09c88bdf19de5ef2023-03-03T05:31:25ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01182e027976510.1371/journal.pone.0279765Effect of remdesivir on adverse kidney outcomes in hospitalized patients with COVID-19 and impaired kidney function.Rituvanthikaa SeethapathyQiyu WangSophia ZhaoIan A StrohbehnJoshua D LongJames E DinulosDestiny HardenVinay B KadiyalaDaiana MorenoMeghan E Sise<h4>Background</h4>Chronic kidney disease (CKD) is an important risk factor for mortality from COVID-19. Remdesivir has been shown to shorten time to recovery in patients with severe COVID-19. However, exclusion of patients with severe kidney function impairment in clinical trials has led to concerns about kidney safety of remdesivir in patients with pre-existing kidney disease.<h4>Methods</h4>Retrospective propensity score matched cohort study of hospitalized patients with COVID-19 admitted with estimated glomerular filtration rate (eGFR) between 15 - 60 mL/min/1.73m2. Remdesivir-treated patients were 1:1 matched to historical comparators admitted during the first wave of COVID-19 (between March-April 2020) prior to emergency use authorization of remdesivir using propensity scores accounting for factors predicting treatment assignment. Dependent outcomes included in-hospital peak creatinine, incidence of doubling of creatine, rate of kidney replacement therapy initiation and eGFR among surviving patients at day 90.<h4>Results</h4>175 remdesivir-treated patients were 1:1 matched to untreated historical comparators. Mean age was 74.1 (SD 12.8), 56.9% were male, 59% patients were white, and the majority (83.1%) had at least one co-morbidity. There were no statistically significant differences in peak creatinine during hospitalization (2.3mg/dL vs. 2.5 mg/dL, P = 0.34), incidence of doubling of creatinine (10.3% vs. 13.1%, P = 0.48), and rate of kidney replacement therapy initiation (4.6% vs. 6.3%, P = 0.49) in remdesivir-treated patients versus matched untreated historical comparators, respectively. Among surviving patients, there was no difference of the average eGFR at day 90 (54.7 ± 20.0 mL/min/1.73m2 for remdesivir-treated patients vs. 51.7 ± 19.5 mL/min/1.73m2 for untreated comparators, P = 0.41).<h4>Conclusions</h4>Remdesivir use in patients with impaired kidney function (eGFR between 15 - 60 mL/min/1.73m2) who present to the hospital with COVID-19 is not associated with increased risk of adverse kidney outcomes.https://doi.org/10.1371/journal.pone.0279765 |
| spellingShingle | Rituvanthikaa Seethapathy Qiyu Wang Sophia Zhao Ian A Strohbehn Joshua D Long James E Dinulos Destiny Harden Vinay B Kadiyala Daiana Moreno Meghan E Sise Effect of remdesivir on adverse kidney outcomes in hospitalized patients with COVID-19 and impaired kidney function. PLoS ONE |
| title | Effect of remdesivir on adverse kidney outcomes in hospitalized patients with COVID-19 and impaired kidney function. |
| title_full | Effect of remdesivir on adverse kidney outcomes in hospitalized patients with COVID-19 and impaired kidney function. |
| title_fullStr | Effect of remdesivir on adverse kidney outcomes in hospitalized patients with COVID-19 and impaired kidney function. |
| title_full_unstemmed | Effect of remdesivir on adverse kidney outcomes in hospitalized patients with COVID-19 and impaired kidney function. |
| title_short | Effect of remdesivir on adverse kidney outcomes in hospitalized patients with COVID-19 and impaired kidney function. |
| title_sort | effect of remdesivir on adverse kidney outcomes in hospitalized patients with covid 19 and impaired kidney function |
| url | https://doi.org/10.1371/journal.pone.0279765 |
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