Acute Kidney Injury and Drugs Prescribed for COVID-19 in Diabetes Patients: A Real-World Disproportionality Analysis
Zhou et al.
, Acute Kidney Injury and Drugs Prescribed for COVID-19 in Diabetes Patients: A Real-World Disproportionality..
, Frontiers in Pharmacology, doi:10.3389/fphar.2022.833679
FAERS analysis showing significantly increased risk of acute kidney injury with remdesivir.
Zhou et al., 17 Mar 2022, peer-reviewed, 6 authors.
Abstract: ORIGINAL RESEARCH
published: 17 March 2022
Acute Kidney Injury and Drugs
Prescribed for COVID-19 in Diabetes
Patients: A Real-World
Yu Zhou 1, Jianbin Li 1, Linyao Wang 1, Xinyan Zhu 1, Meilian Zhang 2* and Jiaping Zheng 3*
Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fujian Medical University, Fuzhou, China,
Department of Ultrasound, Fujian Provincial Maternity and Child Health Hospital, Fuzhou, China, 3Department of Rehabilitation
Medicine, School of Health, Fujian Medical University, Fuzhou, China
Background: The information is relatively scarce regarding the occurrence of druginduced acute kidney injury (AKI) when anti-coronavirus disease 2019 (COVID-19) drugs
are prescribed for patients with diabetes mellitus (DM).
Indian Council of Medical Research
National Defence University of
The University of Tokyo, Japan
This article was submitted to
a section of the journal
Frontiers in Pharmacology
Received: 13 December 2021
Accepted: 14 February 2022
Published: 17 March 2022
Zhou Y, Li J, Wang L, Zhu X, Zhang M
and Zheng J (2022) Acute Kidney Injury
and Drugs Prescribed for COVID-19 in
Diabetes Patients: A Real-World
Front. Pharmacol. 13:833679.
Objective: The objective of this study was to evaluate a pharmacovigilance signal for AKI
upon the use of common drugs prescribed for COVID-19 treatment, especially in patients
Methods: The FDA Adverse Event Reporting System (FAERS) database were used, and
data from the ﬁrst quarter of 2020 to the third quarter of 2021 were retrieved. A
disproportionality analysis was performed to determine whether AKI was more
frequently reported with anti-COVID-19 drugs compared to that with other drugs in
different populations. Further, reporting odds ratios (RORs) and their 95% conﬁdence
intervals (CIs) were used to calculate disproportionality.
Results: We identiﬁed 33,488 COVID-19 patients and 2397 COVID-19 patients with DM.
AKI was the most frequent adverse drug reaction (ADR) reported in this patient population.
The primary suspected drugs related to AKI in more than half of the reports (75.60%, 127/
168) were four common anti-COVID-19 drugs (remdesivir, tocilizumab,
hydroxychloroquine, and lopinavir/ritonavir). Compared with other drugs in the same
time window, remdesivir and lopinavir/ritonavir were associated with an increased risk
of AKI in all COVID-19 patients (ROR: 3.97, 95% CI: 3.51–4.50; ROR: 4.02, 95% CI:
3.11–5.19, respectively). In COVID-19 patients with DM, remdesivir was signiﬁcantly
associated with AKI (ROR: 5.65, 95% CI: 4.06–7.87); meanwhile, there was a new AKI
signal associated with tocilizumab (ROR: 2.37, 95% CI: 1.19–4.72). After sensitivity
analyses in COVID-19 patients with DM, consistent results for remdesivir were
observed; however, the AKI signals for tocilizumab were unstable.
Conclusion: Our study conﬁrmed the association of AKI with the usage of common antiCOVID-19 drugs (especially remdesivir and tocilizumab) in DM patients. These safety
signals suggested more individualized treatments for COVID-19 patients with
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