Safety and Tolerability of Remdesivir in Patients with End-stage Renal Disease on Maintenance Hemodialysis

Shah, Maulin; Mital, Premlata; Prajapati, Dhavalkumar; Bhende, Punam; Prajapati, Abhishek; Chhajwani, Sunil H; Yajnik, Krushan; Ganjiwale, Jaishree; Mannari, Jyoti; Vaishnav, Bhalendu

doi:10.5005/jp-journals-10071-24168

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…There is a paucity of randomized controlled trials on the safety and efficacy of remdesivir in patients with renal impairment having GFR < 30 mL/min due to devastating complications related to the prolonged half-life of the drug itself and its vehicle sulfobutylether-β-cyclodextrin (SBECD) [26]. That said, there have been reports of the use of remdesivir to treat COVID-19 in hemodialysis patients, though the doses varied [27][28][29].…”

Section: Discussionmentioning

confidence: 99%

A maintenance hemodialysis patient complicated with hypogammaglobulinemia presenting typical COVID-19 pneumonia CT findings: a case report

Miyazaki,

Miyagi,

Hirayama

2024

Ren Replace Ther

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Background With the widespread use of the vaccine and the predominance of the Omicron strain, the number of patients presenting with typical coronavirus-infection disease 2019 (COVID-19) pneumonia on computed tomography (CT) has decreased dramatically. This has also been true for hemodialysis patients. Case report A 72-year-old female maintenance hemodialysis patient with hypogammaglobulinemia was diagnosed with COVID-19 based on a nasopharyngeal swab severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) polymerase chain reaction (PCR) test. She had previously received five doses of COVID-19 BNT162b2 vaccine. Initially, the patient had only a slight fever, mild sore throat and sputum, and molnupiravir 1600 mg/day was administered for 5 days. No high fever was observed during that period. On day 11 after diagnosis, bloody sputum was observed, and by day 13 the cough had worsened and her CRP level had increased to 13.10 mg/dL. Chest CT performed on the same day showed multiple subpleural ground-glass-like shadows typical of COVID-19 pneumonia predominantly in the right lung. She was immediately admitted to the hospital, where her temperature rose to 38.4 °C. Intravenous remdesivir 100 mg/day was administered for 5 days. This resolved her fever and the bloody sputum disappeared. She was discharged from the hospital without sequelae on the 21st day after diagnosis. Conclusion We experienced a case of typical COVID-19 pneumonia in a patient on maintenance hemodialysis who had received five doses of COVID-19 BNT162b2 vaccine. There was a flare-up of symptoms after administration of molnupiravir, suggesting that a hypogammaglobulinemia complication was involved. This highlights the need for attention to its potential transition to severe disease when patients with hypogammaglobulinemia or other highly immunocompromised conditions are affected by COVID-19.

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Section: Discussionmentioning

confidence: 99%

A maintenance hemodialysis patient complicated with hypogammaglobulinemia presenting typical COVID-19 pneumonia CT findings: a case report

Miyazaki,

Miyagi,

Hirayama

2024

Ren Replace Ther

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“…[ 24 ] Similar to our study, a statistically significant decrease in total leukocyte count, absolute lymphocyte counts and C-reactive protein was found post-remdesivir treatment in patients with end-stage renal disease. [ 25 ] In the NOR-solidarity trial, 185 patients were randomly assigned to the remdesivir or standard of care group. Secondary outcomes included changes in the degree of respiratory failure and inflammatory variables.…”

Section: Discussionmentioning

confidence: 99%

Impact of Remdesivir on inflammatory and prognostic markers of COVID-19: Findings of an event-monitoring study

Singh,

Sinha,

Lohani

et al. 2023

Journal of Family Medicine and Primary Care

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Introduction: Remdesivir is currently approved for treating hospitalised patients with COVID-19. However, it is a priority to monitor its safety and effectiveness in various clinical settings. This study was undertaken to assess the impact of remdesivir on inflammatory and prognostic markers of COVID-19. Materials and Methods: A hospital-based prospective longitudinal study was conducted over two months comprising event monitoring of COVID-19 patients administered remdesivir as per standard guidelines. The demographic details, risk factors and all baseline parameters were collected. The patients were followed up for the appearance of any adverse drug reactions (ADRs) after the start of remdesivir therapy from Day 1 to discharge or death every day. Repeat Lab tests were done on days 2, 4, 6 and 10 days to assess the impact of remdesivir on inflammatory and prognostic markers of COVID-19 over time. Significant predictors of survival in the cohort were also assessed. Results: A total of 60 COVID-19 patients were administered remdesivir. The mean age of the patients was 59.2 (+13.7) years. There was a significant improvement in the serum creatinine (decreased from 0.9 to 0.7 mg/dL), lymphocyte count {decreased from 9.2 to 7.3 (109 cells/L)} and serum sodium (increased from 134.6 to 137.4) of the patients over six days after the administration of remdesivir. The significant survival predictors were multiple organ failure (P 0.046) and WBC count on Day 10 (P 0.001). Conclusion: Remdesivir administration improved the prognostic biomarker profile in COVID-19 patients.

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Remdesivir

2022

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Safety and Tolerability of Remdesivir in Patients with End-stage Renal Disease on Maintenance Hemodialysis

Cited by 3 publications

References 22 publications

A maintenance hemodialysis patient complicated with hypogammaglobulinemia presenting typical COVID-19 pneumonia CT findings: a case report

A maintenance hemodialysis patient complicated with hypogammaglobulinemia presenting typical COVID-19 pneumonia CT findings: a case report

Impact of Remdesivir on inflammatory and prognostic markers of COVID-19: Findings of an event-monitoring study

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