Abstract
Abstract Background and Aims Remdesivir has shown better patient outcomes and shorter time to recovery among hospitalized patients with moderate to severe COVID-19 pneumonia. However, data on its safety and efficacy in dialysis patients is lacking. Method Dialysis patients with moderate to severe COVID-19 pneumonia who were given remdesivir were matched 1:2 to those who received standard-of-care (SOC) based on age, sex, COVID-19 severity and CKD etiology. Results The final cohort comprised 201 patients and 67 were given remdesivir. Median age was 52 years, majority were male (51.7%), 94% were on hemodialysis (94%) and 48% had diabetic nephropathy. The 28-day probability of survival among moderate COVID-19 cases was 100% for both remdesivir and SOC group. In severe cases, the survival probability for remdesivir recipients was lower compared to SOC (67.63% vs 87.72%), but this was not statistically significant. Overall, median length of stay (LOS) was significantly shorter by 17 days (QR: 11-24) in the remdesivir group, compared to 21 days [IQR: 16-24] in the SOC group (p = 0.0485). Median LOS in the remdesivir group was only significantly shorter in those with moderate COVID-19 pneumonia but not in severe cases. Early administration of remdesivir resulted in a significantly shorter LOS with a median of 10 days [IQR: 7-15] compared to18 days [IQR: 13-25] in the SOC group (p = 0.0240). When stratified by severity, there was no significant difference whether remdesivir was given early or late. Conclusion Remdesivir administration within 48 hours of admission in maintenance dialysis patients with moderate COVID-19 pneumonia resulted in a significantly shorter LOS. However, there was no significant difference in 28-day mortality in early or late administration of remdesivir in both moderate and severe COVID-19 pneumonia among HD patients. Thus, survival was similar to SOC. Our study showed that it is safe to use in dialysis patients.
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