Liver and kidney function in patients with Covid-19 treated with remdesivir

Br J Clin Pharmacol. 2021 Nov;87(11):4450-4454. doi: 10.1111/bcp.14831. Epub 2021 May 4.

Abstract

For the treatment of Covid-19 patients with remdesivir, poor renal and liver function were both exclusion criteria in randomized clinical trials and contraindication for treatment. Also, nephrotoxicity and hepatotoxicity are reported as adverse events. We retrospectively reviewed renal and liver functions of Covid-19 103 patients who received remdesivir in the 15 days after treatment initiation. Approximately 20% of the patient population met randomized clinical trial exclusion criteria. In total, 11% of the patients had a decrease in estimated glomerular filtration rate >10 mL/min/1.73m2 . Also, 25 and 35% had increased alanine transaminase and aspartate transaminase levels, respectively. However, serious adverse events were limited. Therefore, based on these preliminary results, contraindications based on kidney and liver function should not be absolute for remdesivir treatment in patients with Covid-19 if these functions are monitored regularly. A larger patient cohort is warranted to confirm our results.

Keywords: Covid-19; adverse events; liver function; remdesivir; renal function.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives
  • Alanine / analogs & derivatives
  • Antiviral Agents / therapeutic use
  • COVID-19 Drug Treatment*
  • Humans
  • Kidney
  • Liver
  • Retrospective Studies
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Antiviral Agents
  • remdesivir
  • Adenosine Monophosphate
  • Alanine