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

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.

Abnormal Liver Biochemistry Tests and Acute Liver Injury in COVID-19 Patients: Current Evidence and Potential Pathogenesis

“…There are also other studies that have found liver function test abnormalities in remdesivir-treated COVID-19 patients with 23% of patients with elevated liver enzymes in a case series (n = 53) [40], and elevated serum aminotransferases and total bilirubin in 5% and 10% respectively of COVID-19 patients in a multicenter, randomized, double-blind, placebo-controlled study [41]. Finally, in a recently retrospective study of 103 COVID-19 patients, 35% of participants had increased AST and 25% elevated ALT levels indicating the hepatotoxic effect of remdesivir therapy [42].…”

Abnormal Liver Biochemistry Tests and Acute Liver Injury in COVID-19 Patients: Current Evidence and Potential Pathogenesis

“…There are also other studies that have found liver function test abnormalities in remdesivir-treated COVID-19 patients with 23% of patients with elevated liver enzymes in a case series (n = 53) [66], and elevated serum aminotransferases and total bilirubin in 5% and 10% of COVID-19 patients in a multicenter, randomized, double-blind, placebo-controlled study [67]. Finally, in a recently retrospective study of 103 COVID-19 patients, 35% of participants had increased AST and 25% elevated ALT levels indicating the hepatotoxic effect of remdesivir therapy [68].…”

Treosulfan-induced myalgia in pediatric hematopoietic stem cell transplantation identified by an electronic health record text mining tool

“…Furthermore, the use of an electronic health record text mining tool has proven to be helpful in tracking adverse events. More studies have been published using CTcue or a comparable tool to retrieve data from the EHR, including a validation study 27 , 30 , 31 . In the future, in case of a suspicion of the occurrence of a specific adverse event, a text mining tool can efficiently extract data from EHRs and can therefore quickly provide clarity on the relationship with the use of a particular drug.…”