Efficacy of remdesivir for hospitalized COVID-19 patients with end stage renal disease

World J Crit Care Med. 2022 Jan 9;11(1):48-57. doi: 10.5492/wjccm.v11.i1.48.

Abstract

Background: Since the beginning of corona virus disease 2019 (COVID-19) pandemic, there has been a widespread use of remdesivir in adults and children. There is little known information about its outcomes in patients with end stage renal disease who are on dialysis.

Aim: To assess the clinical outcomes with use of remdesivir in adult patients with end stage kidney failure on hemodialysis.

Methods: A retrospective, multicenter study was conducted on patients with end stage renal disease on hemodialysis that were discharged after treatment for COVID-19 between April 1, 2020 and December 31, 2020. Primary endpoints were oxygen requirements, time to mortality and escalation of care needing mechanical ventilation.

Results: A total of 45 patients were included in the study. Twenty patients received remdesivir, and 25 patients did not receive remdesivir. Most patients were caucasian, females with diabetes mellitus and hypertension being the commonest comorbidities. There was a trend towards reduced oxygen requirement (beta = -25.93, X 2 (1) = 6.65, P = 0.0099, probability of requiring mechanical ventilation (beta = -28.52, X 2 (1) = 22.98, P < 0.0001) and mortality (beta = -5.03, X 2 (1) = 7.41, P = 0.0065) in patients that received remdesivir compared to the control group.

Conclusion: Larger studies are justified to study the effects of remdesivir in this high-risk population with end stage kidney disease on dialysis.

Keywords: COVID-19; Dialysis; End stage renal disease; Hemodialysis; Kidney disease; Remdesivir.