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Use and safety of remdesivir in kidney transplant recipients with COVID-19

Autores: Buxeda, A.; Arias-Cabrales, C.; Pérez-Sáez, M. J.; Cacho, J.; Cabello Pelegrín, S.; Melilli, E.; Aladren, M. J.; Galeano, C.; Lorenzo, I.; Mazuecos, A.; Saura, I. M.; Franco, A.; Ruiz-Fuentes, M. C.; Sánchez-Cámara, L. A.; Siverio, O.; Martín, M. L.; González-García, E.; López, V.; Martín Moreno, Paloma Leticia; Moina, I.; Moral Berrio, E.; Moreso, F.; Portoles, J. M.; Santana-Estupiñán, R.; Zarraga, S.; Canal, C.; Sánchez-Álvarez, E.; Pascual, J. (Autor de correspondencia); Crespo, M. (Autor de correspondencia); Spanish Society of Nephrology COVID-19 Group
ISSN: 2468-0249
Volumen: 6
Número: 9
Páginas: 2305 - 2315
Fecha de publicación: 2021
Introduction: Remdesivir has demonstrated antiviral activity against coronavirus, shortening the time to recovery in adults hospitalized with moderate/severe COVID-19. Severe adverse events such as acute kidney injury have been reported. Scant data are available on the use and safety of remdesivir in kidney transplant recipients. Methods: We present a multicenter cohort study of 51 kidney transplant recipients with COVID-19 treated with remdesivir. Outcomes and safety were assessed. Results: Mean age at diagnosis was 60 years, with a median time since kidney transplant of 4.5 years. Mean time since admission to remdesivir was 2 days. Twenty-eight patients (54.9%) required mechanical ventilation (19 noninvasive). Mortality was 18.9% and markedly higher if aged >= 65 years (45% vs. 3.2% in younger patients). Acute kidney injury was present in 27.7% of patients, but was diagnosed in 50% before treatment. No patients required remdesivir discontinuation because of adverse events. We did not find significant hepatoxicity or systemic symptoms resulting from the drug. Conclusion: In our cohort of kidney transplant recipients, remdesivir was well tolerated and safe in renal and hepatic toxicity, but randomized trials are needed to assess its efficacy.