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Use and Safety of Remdesivir in Kidney Transplant Recipients With COVID-19

2021; Elsevier BV; Volume: 6; Issue: 9 Linguagem: Inglês

10.1016/j.ekir.2021.06.023

2468-0249

Anna Buxeda, Carlos Arias-Cabrales, María José Pérez‐Sáez, Judit Cacho, Sheila Cabello Pelegrín, Edoardo Melilli, María José Aladrén, C. Galéano, Inmaculada Lorenzo, Auxiliadora Mazuecos, Isabel María Saura, Antonio Franco, María del Carmen Ruiz-Fuentes, Luis Sánchez-Cámara, Orlando Siverio, Marisa Martín, Elena González, Verónica López, Paloma Leticia Martín-Moreno, Iñigo Moina, Esperanza Moral Berrio, Francesc Moreso, José Pórtoles, Raquel Santana‐Estupiñán, Sofía Zárraga, Cristina Canal, Emilio Sánchez-Álvarez, Julio Pascual, Marta Crespo,

Infectious Encephalopathies and Encephalitis

Remdesivir has demonstrated antiviral activity against coronavirus, shortening the time to recovery in adults hospitalized with moderate/severe COVID-19. Severe adverse events such as acute kidney injury have been reported. Scant data are available on the use and safety of remdesivir in kidney transplant recipients.We present a multicenter cohort study of 51 kidney transplant recipients with COVID-19 treated with remdesivir. Outcomes and safety were assessed.Mean age at diagnosis was 60 years, with a median time since kidney transplant of 4.5 years. Mean time since admission to remdesivir was 2 days. Twenty-eight patients (54.9%) required mechanical ventilation (19 noninvasive). Mortality was 18.9% and markedly higher if aged ≥65 years (45% vs. 3.2% in younger patients). Acute kidney injury was present in 27.7% of patients, but was diagnosed in 50% before treatment. No patients required remdesivir discontinuation because of adverse events. We did not find significant hepatoxicity or systemic symptoms resulting from the drug.In our cohort of kidney transplant recipients, remdesivir was well tolerated and safe in renal and hepatic toxicity, but randomized trials are needed to assess its efficacy.