IDCases (Jan 2021)
Extracorporeal membrane oxygenation may decrease the plasma concentration of remdesivir in a patient with severe coronavirus disease 2019
- Satoshi Ide,
- Sho Saito,
- Tsubasa Akazawa,
- Takahito Furuya,
- Junichi Masuda,
- Maki Nagashima,
- Yusuke Asai,
- Tatsunori Ogawa,
- Ryohei Yamamoto,
- Haruhiko Ishioka,
- Kohei Kanda,
- Ayako Okuhama,
- Yuji Wakimoto,
- Tetsuya Suzuki,
- Yutaro Akiyama,
- Yusuke Miyazato,
- Keiji Nakamura,
- Takato Nakamoto,
- Hidetoshi Nomoto,
- Yuki Moriyama,
- Masayuki Ota,
- Shinichiro Morioka,
- Wataru Matsuda,
- Tatsuki Uemura,
- Kentaro Kobayashi,
- Ryo Sasaki,
- Daisuke Katagiri,
- Satoshi Kutsuna,
- Kayoko Hayakawa,
- Norio Ohmagari
Affiliations
- Satoshi Ide
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan; Correspondence to: Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
- Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tsubasa Akazawa
- Pharmaceutical Department, National Center for Global Health and Medicine, Tokyo, Japan
- Takahito Furuya
- Pharmaceutical Department, National Center for Global Health and Medicine, Tokyo, Japan
- Junichi Masuda
- Pharmaceutical Department, National Center for Global Health and Medicine, Tokyo, Japan
- Maki Nagashima
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Yusuke Asai
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
- Tatsunori Ogawa
- Medical Equipment Management Office, National Center for Global Health and Medicine, Tokyo, Japan
- Ryohei Yamamoto
- Department of Healthcare Epidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Haruhiko Ishioka
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
- Kohei Kanda
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Ayako Okuhama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Yuji Wakimoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
- Yutaro Akiyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Yusuke Miyazato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Keiji Nakamura
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Takato Nakamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
- Yuki Moriyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
- Masayuki Ota
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
- Wataru Matsuda
- Department of Emergency Medicine and Critical Care, Trauma Center, National Center for Global Health and Medicine, Tokyo, Japan
- Tatsuki Uemura
- Department of Emergency Medicine and Critical Care, Trauma Center, National Center for Global Health and Medicine, Tokyo, Japan
- Kentaro Kobayashi
- Department of Emergency Medicine and Critical Care, Trauma Center, National Center for Global Health and Medicine, Tokyo, Japan
- Ryo Sasaki
- Department of Emergency Medicine and Critical Care, Trauma Center, National Center for Global Health and Medicine, Tokyo, Japan
- Daisuke Katagiri
- Department of Nephrology, National Center for Global Health and Medicine, Tokyo, Japan
- Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
- Journal volume & issue
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Vol. 26
p. e01343
Abstract
Remdesivir is an antiviral drug that results in clinical improvement after five days of treatment and accelerates recovery by 31%. No studies have discussed the pharmacokinetic analysis of remdesivir in patients with severe COVID-19 requiring extracorporeal membrane oxygenation (ECMO). A 63-year-old American man who underwent mechanical ventilation and ECMO for severe COVID-19 was administered remdesivir for ten days. The loading dosage was 200 mg at 7 PM on day 12 and 100 mg daily at 0:00 PM from day 13–21, administered within 1 h. The pharmacokinetic analysis was performed. The serum creatinine concentration was within the normal range of 0.5–0.7 mg/dL during treatment. According to the pharmacokinetic analysis, the plasma concentrations of remdesivir and GS-441524 4 h after administration (C4) were 662 ng/mL and 58 ng/mL, respectively, and the concentrations 18 h after administration (C18) were 32 ng/mL and 44 ng/mL, respectively. Therefore, the half-life of remdesivir and GS-441524 was 3.2 and 35.1 h, respectively. Monitoring the plasma concentrations of remdesivir and GS-441524 in patients undergoing ECMO may be necessary.
