Selvaraj V, Lal A, Finn A, Tanzer JR, Baig M, Jindal A, Dapaah-Afriyie K, Bayliss G. Efficacy of remdesivir for hospitalized COVID-19 patients with end stage renal disease. World J Crit Care Med 2022; 11(1): 48-57 [PMID: 35433306 DOI: 10.5492/wjccm.v11.i1.48]
Corresponding Author of This Article
Amos Lal, FACP, MBBS, Assistant Professor, Department of Medicine, Division of Pulmonary and Critical Care, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, United States. manavamos@gmail.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Jan 9, 2022; 11(1): 48-57 Published online Jan 9, 2022. doi: 10.5492/wjccm.v11.i1.48
Efficacy of remdesivir for hospitalized COVID-19 patients with end stage renal disease
Vijairam Selvaraj, Amos Lal, Arkadiy Finn, Joshua Ray Tanzer, Muhammad Baig, Atin Jindal, Kwame Dapaah-Afriyie, George Bayliss
Vijairam Selvaraj, Arkadiy Finn, Muhammad Baig, Atin Jindal, Kwame Dapaah-Afriyie, Department of Medicine, Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI 02906, United States
Amos Lal, Department of Medicine, Division of Pulmonary and Critical Care, Mayo Clinic, Rochester, MN 55905, United States
Joshua Ray Tanzer, Department of Biostatistics Core, Lifespan Group, Providence, RI 02906, United States
George Bayliss, Department of Medicine, Rhode Island Hospital and Alpert Medical School, Bayliss, Division of Kidney and Hypertension, Brown University, Providence, RI 02906, United States
Author contributions: Selvaraj V, Finn A and Lal A were responsible for the conception and design of the work, screening of papers and drafting the manuscript; Jindal A was responsible for the literature review and contributed to manuscript writing; Tanzer JR and Baig M performed analysis and final approval; Jindal A, Dapaah-Afriyie K and Bayliss G contributed to research oversight, data review and manuscript revision.
Institutional review board statement: Institutional review board statement: This study was reviewed and approved by the IRB of the Miriam Hospital. IRB # 20-054
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Noncommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amos Lal, FACP, MBBS, Assistant Professor, Department of Medicine, Division of Pulmonary and Critical Care, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, United States. manavamos@gmail.com
Received: June 2, 2021 Peer-review started: June 2, 2021 First decision: July 31, 2021 Revised: August 4, 2021 Accepted: December 23, 2021 Article in press: Deccember 23, 2021 Published online: January 9, 2022 Processing time: 216 Days and 7.4 Hours
Abstract
BACKGROUND
Since the beginning of corona virus disease 2019 (COVID-19) pandemic, there has been a widespread use of remdesivir in adults and children. There is little known information about its outcomes in patients with end stage renal disease who are on dialysis.
AIM
To assess the clinical outcomes with use of remdesivir in adult patients with end stage kidney failure 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 1, 2020 and December 31, 2020. Primary endpoints were oxygen requirements, time to mortality and escalation of care needing mechanical ventilation.
RESULTS
A total of 45 patients were included in the study. Twenty patients received remdesivir, and 25 patients did not receive remdesivir. Most patients were caucasian, females with diabetes mellitus and hypertension being the commonest comorbidities. There was a trend towards reduced oxygen requirement (beta = -25.93, X2 (1) = 6.65, P = 0.0099, probability of requiring mechanical ventilation (beta = -28.52, X2 (1) = 22.98, P < 0.0001) and mortality (beta = -5.03, X2 (1) = 7.41, P = 0.0065) in patients that received remdesivir compared to the control group.
CONCLUSION
Larger studies are justified to study the effects of remdesivir in this high-risk population with end stage kidney disease on dialysis.
Core Tip: Little known information exists regarding the efficacy of remdesivir in corona virus disease 2019 patients with end stage renal disease on dialysis. Use of remdesivir was associated with a trend towards reduced oxygen requirement, reduced probability of progression to mechanical ventilation and better prognosis. Larger studies are justified in this high risk, vulnerable population.
