#5624 REMDESIVIR IN COVID-19 PATIENTS WITH KIDNEY DISEASE: A STUDY ON THE RENAL FUNCTION AND OUTCOMES

Abstract

Abstract Background and Aims The COVID-19 pandemic has created a global catastrophe with mortality rates higher in older adults and people with chronic comorbid conditions In which patients with chronic kidney disease were the most vulnerable population. Remdisivir, an antiviral nucleotide, showed promising results in individuals with COVID-19 infection. However, despite its shortened time to recovery in adults hospitalized with COVID 19, individuals with ESRD and high stage AKI were not included in clinical trials, thus when granted an emergency use authorization it was recommended to avoid use in patients with eGFR <30mL/min “unless benefit outweighs the risk”. In this study, in the absence of Molnupiravir, the current drug of choice, we wished to study its safety by determining its effects on renal status of individuals with known kidney dysfunction. The study aims to determine the effect of Remdesivir on renal function and outcomes among COVID19 patients with kidney disease. Method The study utilized a retrospective research design. The study included patients who were 19 years old and above, with RT-PCR confirmed COVID19 infection treated with Remdesivir and who were confirmed to have kidney disease. Results 106 patients were included; the mean age was 62.25±13.96 years old, more than half of the population were males. The majority of the population had AKI while the rest had CKD and 25% underwent renal replacement therapy. Most of them were classified with severe and critical COVID infection (Table 1). To determine effects on renal function laboratory parameters were determined at baseline and after completion of treatment. There was an overall significant improvement in egfr (<0.01), albuminuria (0.013) and in acid-base balance (0.003) and odds ratio showed that none of the demographic, clinical and laboratory profile significantly in-creased the chance of death in terms of overall clinical outcome (Table 2). To determine risk factors of patients that may contribute to patients outcome, odds ratio showed that none of the demographic, clinical and laboratory profile significantly increased the chance of death among patients who took Remdesivir. (Table 3). In terms of overall clinical outcome, this study had a mortality rate of 4.9% (Table 4). Conclusion Use of Remdesivir in patients with AKI, CKD and ESRD on dialysis was not associated with further renal function deterioration. Contrary to concerns there was rather an overall significant improvement in EGFR, degree of albuminuria and acid-base balance after treatment regardless of their disease severity and its use in patients on hemodialysis have not shown any detrimental impact on mortality.