Nirmatrelvir/ritonavir use in patients with COVID-19 on hemodialysis: a case series

Diagn Microbiol Infect Dis. 2023 Nov;107(3):115969. doi: 10.1016/j.diagmicrobio.2023.115969. Epub 2023 Apr 26.

Abstract

Patients undergoing hemodialysis (HD) are particularly vulnerable to coronavirus disease 2019 (COVID-19) and are at increased risk of developing severe infection. However, given the exclusion of such patients from clinical trials, there are limited data regarding the effectiveness of the antiviral drug nirmatrelvir/ritonavir (N/R) in patients on HD. We prescribed N/R to 4 patients on HD with COVID-19 after obtaining informed consent. Their clinical symptoms were improved at approximately 3 days after N/R administration. The viral load was reduced after approximately 10 days. The main adverse effects were nausea and vomiting. Rational dosage adjustment obtained good tolerance but did not influence the efficacy. These results suggest that N/R may be a promising agent for patients on HD with COVID-19.

Keywords: COVID-19; Hemodialysis; Nirmatrelvir/ritonavir.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents / adverse effects
  • COVID-19 Drug Treatment
  • COVID-19*
  • Humans
  • Renal Dialysis / adverse effects
  • Ritonavir / therapeutic use

Substances

  • nirmatrelvir
  • Ritonavir
  • Antiviral Agents