Use of remdesivir in kidney transplant recipients with SARS-CoV-2 Omicron infection
et al., Kidney International, doi:10.1016/j.kint.2022.08.001, Oct 2022
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 increased risk of acute kidney injury, Leo, Briciu, Muntean, Petrov show increased risk of liver injury, and Negru, Cheng, Mohammed show increased risk of cardiac disorders with remdesivir.
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risk of death, 79.8% higher, RR 1.80, p = 0.70, treatment 5 of 57 (8.8%), control 2 of 41 (4.9%).
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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%).
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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%).
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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%).
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| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
1.
Gérard et al., Remdesivir and Acute Renal Failure: A Potential Safety Signal From Disproportionality Analysis of the WHO Safety Database, Clinical Pharmacology & Therapeutics, doi:10.1002/cpt.2145.
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Zhou et al., Acute Kidney Injury and Drugs Prescribed for COVID-19 in Diabetes Patients: A Real-World Disproportionality Analysis, Frontiers in Pharmacology, doi:10.3389/fphar.2022.833679.
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Wu et al., Acute Kidney Injury Associated With Remdesivir: A Comprehensive Pharmacovigilance Analysis of COVID-19 Reports in FAERS, Frontiers in Pharmacology, doi:10.3389/fphar.2022.692828.
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Kamo et al., Association of Antiviral Drugs for the Treatment of COVID-19 With Acute Renal Failure, In Vivo, doi:10.21873/invivo.13637.
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Choi et al., Comparative effectiveness of combination therapy with nirmatrelvir–ritonavir and remdesivir versus monotherapy with remdesivir or nirmatrelvir–ritonavir in patients hospitalised with COVID-19: a target trial emulation study, The Lancet Infectious Diseases, doi:10.1016/S1473-3099(24)00353-0.
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Kim et al., Investigating the Safety Profile of Fast‐Track COVID‐19 Drugs Using the FDA Adverse Event Reporting System Database: A Comparative Observational Study, Pharmacoepidemiology and Drug Safety, doi:10.1002/pds.70043.
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Leo et al., Hepatocellular liver injury in hospitalized patients affected by COVID-19: Presence of different risk factors at different time points, Digestive and Liver Disease, doi:10.1016/j.dld.2021.12.014.
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Briciu et al., Evolving Clinical Manifestations and Outcomes in COVID-19 Patients: A Comparative Analysis of SARS-CoV-2 Variant Waves in a Romanian Hospital Setting, Pathogens, doi:10.3390/pathogens12121453.
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Muntean et al., Effects of COVID-19 on the Liver and Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta and Non-Delta Variants: An Analysis in a Single Centre, Pharmaceuticals, doi:10.3390/ph17010003.
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Petrov et al., The Effect of Potentially Hepatotoxic Medicinal Products on Alanine Transaminase Levels in COVID-19 Patients: A Case–Control Study, Safety and Risk of Pharmacotherapy, doi:10.30895/2312-7821-2025-458.
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Negru et al., Comparative Pharmacovigilance Analysis of Approved and Repurposed Antivirals for COVID-19: Insights from EudraVigilance Data, Biomedicines, doi:10.3390/biomedicines13061387.
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.
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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
is less effective
