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- Title
Outcome of COVID-19 and tolerance of Remdesivir in patients with renal failure: a single center experience from Pakistan.
- Authors
Babar, Zaheer Udin; Dodani, Sunil Kumar; Nasim, Asma; Langhani, Jawahar Lal; Badlani, Sanjay Kumar
- Abstract
Introduction: Coronavirus disease-19 (COVID-19) is known to cause severe disease in chronic kidney disease and maintenance dialysis patients. We aim to report the outcome of COVID-19 and the adverse effects of Remdesivir (RDV) in patients with renal failure. Methodology: A retrospective observational study included all admitted patients with COVID-19 who received Remdesivir. Clinical characteristics and outcomes were compared in patients with renal failure (RF) and non-renal failure (NRF). We also evaluated RDV-associated nephrotoxicity and observed renal functions during antiviral treatment. Results: A total of 142 patients received RDV, 38 (26.76%) in RF and 104 (73.23%) in the non-RF group. The median absolute lymphocyte count was low while C-reactive protein, ferritin, and D-dimer were significantly high on admission in the RF group. A significant number of patients in the RF group required ICU admission (58% vs. 35% p = 0.01) and expired (29% vs. 12.5 p = 0.02). Among survivors and nonsurvivors in the RF group, raised inflammatory markers and low platelet count on presentation were significantly associated with high mortality. Median serum creatinine (mg/dL) was 0.88 on admission, remained at 0.85 in the NRF group, and improved from 4.59 to 3.87 (mg/dL) after receiving five days of RDV in the RF group. Conclusions: COVID-19 in renal failure has a high risk for ICU admissions leading to increased mortality. Multiple comorbidities and raised inflammatory markers are predictors of poor outcomes. We observed no significant drug-related adverse effects, and none of our patients required discontinuation of RDV due to worsening renal function.
- Subjects
PAKISTAN; KIDNEY failure; COVID-19; REMDESIVIR; CHRONIC kidney failure; CORONAVIRUS diseases; LYMPHOCYTE count
- Publication
Journal of Infection in Developing Countries, 2023, Vol 17, Issue 6, p812
- ISSN
2036-6590
- Publication type
Article
- DOI
10.3855/jidc.17136