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Use of remdesivir in kidney transplant recipients with SARS-CoV-2 Omicron infection

Cacho et al., Kidney International, doi:10.1016/j.kint.2022.08.001
Oct 2022  
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Mortality -80% Improvement Relative Risk Severe case -44% Moderate/severe case -73% Discharge -92% Remdesivir for COVID-19  Cacho et al.  LATE TREATMENT Is late treatment with remdesivir beneficial for COVID-19? Retrospective 98 patients in Spain (November 2021 - February 2022) Higher severe cases (p=0.58) and more moderate/severe cases (p=0.087), not sig. c19early.org Cacho et al., Kidney Int., October 2022 Favorsremdesivir Favorscontrol 0 0.5 1 1.5 2+
Retrospective 98 kidney transplant recipients with SARS-CoV-2 Omicron infection in Spain, showing no significant difference in mortality with remdesivir treatment. Earlier administration was associated with improved results, although this analysis is subject to survivorship/selection bias.
Gérard, Zhou, Wu, Kamo, Choi, Kim show significantly increased risk of acute kidney injury with remdesivir.
risk of death, 79.8% higher, RR 1.80, p = 0.70, treatment 5 of 57 (8.8%), control 2 of 41 (4.9%).
risk of severe case, 43.9% higher, RR 1.44, p = 0.58, treatment 10 of 57 (17.5%), control 5 of 41 (12.2%).
risk of moderate/severe case, 72.6% higher, RR 1.73, p = 0.09, treatment 24 of 57 (42.1%), control 10 of 41 (24.4%).
risk of no hospital discharge, 91.8% higher, RR 1.92, p = 0.35, treatment 8 of 57 (14.0%), control 3 of 41 (7.3%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Cacho et al., 31 Oct 2022, retrospective, Spain, peer-reviewed, 15 authors, study period 1 November, 2021 - 28 February, 2022, average treatment delay 5.0 days. Contact: cucchiari@clinic.cat, fdiekman@clinic.cat.
This PaperRemdesivirAll
Abstract: Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. research letter www.kidney-international.org Use of remdesivir in kidney transplant recipients with SARS-CoV-2 Omicron infection Judit Cacho1, David Nicolás2, Marta Bodro3, Elena Cuadrado-Payán1, Verónica Torres-Jaramillo1, Ángela Gonzalez-Rojas1, Pedro Ventura-Aguiar1,2, Enrique Montagud-Marrahi1, Sabina Herrera3, Veronica Rico2, Frederic Cofàn1, Frederic Oppenheimer1, Ignacio Revuelta1,4,5, Fritz Diekmann1,4,5,6 and David Cucchiari1,4,6 1 Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain; 2Hospital-at-Home Unit, Department of Internal Medicine, Hospital Clínic, Barcelona, Spain; 3Department of Infectious Diseases Service, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain; 4Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; and 5Red de Investigación Renal (REDINREN), Madrid, Spain Kidney International (2022) 102, 917–921; https://doi.org/10.1016/ j.kint.2022.08.001 Copyright ª 2022, International Society of Nephrology. Published by Elsevier Inc. All rights reserved. Correspondence: David Cucchiari or Fritz Diekmann, Department of Nephrology and Kidney Transplantation, Hospital Clínic, Carrer Villarroel 170 (Escala 12–Planta 5), 08036 Barcelona, Spain. E-mail: cucchiari@clinic.cat (D. Cucchiari) or fdiekman@clinic.cat (F. Diekmann) 6 FD and DC are contributed equally to this work. Received 20 April 2022; revised 27 July 2022; accepted 4 August 2022; published online 11 August 2022 Kidney International (2022) 102, 917–921 I nfection from the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seems to be less severe in general population in comparison with the previous variants of concern.1 However, in kidney transplant recipients (KTRs), Omicron continues to be a considerable threat2 due to immunosuppression status and blunt response to vaccination.3 Clinical trials with remdesivir have demonstrated improved time to recovery in patients on oxygen with coronavirus disease 2019 (COVID-19).4 In Spain, it was approved in September 2020 for the treatment of COVID-19 in patients with pneumonia, respiratory failure, and less than 8 days since symptoms’ onset. Then, in consideration of the Phase 3 Randomized, Double-Blind Placebo-Controlled Trial to Evaluate the Efficacy and Safety of Remdesivir (GS-5734) Treatment of COVID-19 in an Outpatient Setting (PINETREE), patients with mild symptomatology and comorbidities were also considered to receive treatment with remdesivir because of its safety profile and the lower risk of hospitalization or death than placebo.5 Taking into consideration these..
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Late treatment
is less effective
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