Recent clinical findings published in Scientific Reports by Petr Waldauf and colleagues evaluate how remdesivir impacts renal and liver functions in advanced COVID-19 patients with high illness severity and presence of viral load. According to the research tracking 114 patients, changes in plasma creatinine were independent of remdesivir therapy, with baseline plasma creatinine levels serving as the statistically significant confounders.
Patient Cohort and Baseline Characteristics
The study analyzed 114 patients, where 55.8% were male, with an age of 71 (59; 77) years. According to Waldauf et al., researchers compared laboratory results of patients carrying a detectable viral load treated with remdesivir against the controls. Baseline plasma creatinine in the remdesivir group stood at 150 µmol/l, showing no statistically significant divergence from control measurements.
Renal and Liver Function Impact
Data from the Scientific Reports publication indicate that variations in plasma creatinine levels did not correlate directly with remdesivir administration. Instead, researchers identified that pre-existing baseline plasma creatinine levels significantly influenced subsequent renal function changes during treatment.
In parallel evaluations concerning specialized populations, retrospective data from the Clinical Institute of Urology and Renal Transplantation in Cluj-Napoca, Romania, examined kidney transplant recipients diagnosed with COVID-19 between March 1, 2020, and May 31, 2021. Organ transplant recipients face risks of unfavorable outcomes following SARS-CoV-2 infection due to lifelong immunosuppression and comorbidities, with early pandemic mortality of kidney transplant recipients exceeding 25% according to Oltean et al.
While early clinical trials for antiviral compounds frequently excluded patients with poor liver and kidney function—such as those with a creatinine clearance under 30 or 50 mL/min—due to concerns over potential nephrotoxicity of remdesivir or its inactive ingredient, the solubility enhancer sulfobutylether-β-cyclodextrin, subsequent observational analyses have helped bridge these knowledge gaps. Real-world utilization across diverse geographic areas suggests that remdesivir was well tolerated and safe in kidney transplant recipients with COVID-19.