Use and Safety of Remdesivir in Kidney Transplant Recipients With COVID-19

Abstract

Introduction:Remdesivir has demonstrated antiviral activity against coronavirus, shortening the time torecovery in adults hospitalized with moderate/severe COVID-19. Severe adverse events such as acutekidney injury have been reported. Scant data are available on the use and safety of remdesivir in kidneytransplant recipients.Methods:We present a multicenter cohort study of 51 kidney transplant recipients with COVID-19 treatedwith remdesivir. Outcomes and safety were assessed.Results:Mean age at diagnosis was 60 years, with a median time since kidney transplant of 4.5years. Mean time since admission to remdesivir was 2 days. Twenty-eight patients (54.9%) requiredmechanical ventilation (19 noninvasive). Mortality was 18.9% and markedly higher if aged$65 years(45% vs. 3.2% in younger patients). Acute kidneyinjury was present in 27.7% of patients, but wasdiagnosed in 50% before treatment. No patients required remdesivir discontinuation because ofadverse events. We did notfind significant hepatoxicity or systemicsymptoms resulting from thedrug. Conclusion:In our cohort of kidney transplant recipients, remdesivir was well tolerated and safe in renaland hepatic toxicity, but randomized trials are needed to assess its efficacy.

The authors are indebted to the many physicians andnurses who take care of these patients and are facing theCOVID-19 pandemic in our country. This research wassupported by Rio Hortega contract CM19/00004 (ISCIII)(AB), and RD16/0009/0013 (ISCIII FEDER RedinRen). MJP-S is supported by a Spanish Society of Transplantscholarship