Outcomes of COVID-19 among Patients with End Stage Renal Disease on Remdesivir

Abstract

BACKGROUND: Since the beginning of COVID-19 pandemic, there has been widespread use of remdesivir in adults and children. There is little known information about its outcomes in patients with severe renal dysfunction or end stage renal disease who are 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 1st and December 31st, 2020. Primary endpoints were length of stay, mortality, maximum oxygen requirements along with escalation of care needing mechanical ventilation. Secondary endpoints included change in C reactive protein, d dimer levels and disposition. RESULTS: A total of 52 charts were reviewed, of which 28 met the inclusion criteria. 14 patients received remdesivir, and 14 patients did not receive remdesivir. The majority of patients were caucasian, female, with diabetes mellitus and hypertension. Mean age was 65.33 +14.14 years. All the patients in the remdesivir group received dexamethasone as compared to only 30% of patients in the non-remdesivir group. There was no significant difference in C reactive protein, d dimer levels, and disposition between the two groups. Approximately 35% of the patients died, 18% required intensive ventilation and mean length of stay was 12.21 days. DISCUSSION: The study demonstrated no clinically significant difference in length of stay, maximum oxygen requirements or mortality in COVID-19 patients with end-stage renal disease in the remdesivir group as compared to the non-remdesivir group. Further studies are needed to study the effects of remdesivir on the renal function and disease course in patients with chronic kidney disease stage 4 or 5 that are not on dialysis.

Remdesivir in COVID-19 Patients with End Stage Renal Disease on Hemodialysis

“…There was no statistical difference in mortality, length of stay or maximum oxygen requirement. There was no difference in CRP levels, d dimer levels and rates of mechanical ventilation between the two groups [11] (Table 1).…”