Use and Safety of Remdesivir in Kidney Transplant Recipients With COVID-19
Anna Buxeda, Carlos Arias-Cabrales, María José Pérez‐Sáez, Judit Cacho, Sheila Cabello Pelegrín, Edoardo Melilli, María José Aladrén, C. Galéano, Inmaculada Lorenzo, Auxiliadora Mazuecos, Isabel María Saura, Antonio Franco, María del Carmen Ruiz-Fuentes, Luis Sánchez-Cámara, Orlando Siverio, Marisa Martín, Elena González, Verónica López, Paloma Leticia Martín-Moreno, Iñigo Moina, Esperanza Moral Berrio, Francesc Moreso, José Pórtoles, Raquel Santana‐Estupiñán, Sofía Zárraga, Cristina Canal, Emilio Sánchez-Álvarez, Julio Pascual, Marta Crespo
Abstract
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.