AN OBSERVATIONAL STUDY OF THE USE OF REMDESIVIR IN MODERATE COVID-19 PNEUMONIA IN PATIENTS WITH END STAGE RENAL FAILURE AT A TERTIARY COVID CARE HOSPITAL

Abstract

Background: Patients with end-stage renal disease (ESRD) on maintenance haemodialysis are more prone to the development of severe coronavirus disease 2019 (COVID-19) infection. Use of remdesivir was associated with survival benet in severe COVID-19 patients with ESRD. Aim: The present study evaluated the clinical experience of compassionate outcome and safety prole of remdesivir in patients with end-stage renal disease and moderate to severe COVID-19 infection. Methods: An observational prospective study was conducted in dialysis-dependent patients with COVID-19 infection who received remdesivir as a treatment regimen. Demographic data, state of illness, medical history, laboratory tests, therapeutic intervention, total leucocyte, neutrophils, and lymphocytes, serum concentrations of erythrocyte sedimentation rate, C-reactive protein, ferritin, interleukin-6 level, lactate dehydrogenase, aspartate and alanine transaminases, and D-dimer, and outcome of patients were collected. As per the national guidelines for community-acquired pneumonia patients were classied into mild, moderate, and severe cases. A dose of 100 mg of remdesivir was administered in each patient. Data were analyzed using independent sample t-test, Mann-Whitney U test, chi-square, and Kaplan-Meier survival and mortality test. Results: Out of 38 patients (mean age, 57.4 years), 3 (7.9%), 9 (23.7%), and 26 (68.4%) patients had mild, moderate, and severe COVID-19 infection, respectively. Hypertension (100.0%), type-2 diabetes mellitus (65.8%), and hepatitis C virus (2.6%) were common comorbid conditions. Lymphocyte count was signicantly lower in those patients with severe disease (7.8 vs. 12.5 x 109/L; P=0.036). Eleven patients with severe COVID-19 infection required mechanical ventilation support. Higher lactic dehydrogenase levels were found in patients who died compared to in patients who discharged (850.0 vs. 593.0 U/L; P=0.017). The post-treatment laboratory parameters were within acceptable limits. No patient reported any immediate adverse effects after infusion of remdesivir. Conclusion: Remdesivir was well tolerated and it may be considered as a therapeutic option in the treatment of ESRD patients on maintenance haemodialysis with COVID-19 infection.