Clinical Interventions in Aging (Jun 2021)
Remdesivir, Renal Function and Short-Term Clinical Outcomes in Elderly COVID-19 Pneumonia Patients: A Single-Centre Study
Abstract
Edoardo Biancalana,1,* Martina Chiriacò,1,* Paolo Sciarrone,1 Alessandro Mengozzi,1 Sandra Mechelli,2 Stefano Taddei,1 Anna Solini3 1Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 2Section of General Medicine IV AUOP, University of Pisa, Pisa, Italy; 3Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy*These authors contributed equally to this workCorrespondence: Anna SoliniDepartment of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, I-56126, ItalyTel +39-050993482Fax +39-050553235Email [email protected]: Remdesivir, an antiviral agent able to reduce inflammatory cascade accompanying severe, life-threatening pneumonia, became the first drug approved by the Food and Drug Administration for the treatment of hospitalized patients with coronavirus 2 related severe acute respiratory syndrome (SARS CoV2). As from its previously known clinical indications, the use of remdesivir in the presence of severe renal impairment is contraindicated; however, the impact of remdesivir on renal function in aging patients has not been elucidated.Subjects and Methods: This retrospective observational study involved 109 individuals consecutively admitted in internal medicine section, Azienda Ospedaliero Universitaria Pisana hospital, in November–December 2020 due to a confirmed diagnosis of SARS CoV2 and receiving remdesivir according to international inclusion criteria. Biochemical variables at admission were evaluated, together with slopes of estimated glomerular filtration rate (eGFR) built during remdesivir treatment. Participants were followed until discharge or exitus.Results: Patients were stratified according to age (80 formed the study cohort and 29 served as controls); CKD stage III was present in 46% of them. No patients showed any sign of deteriorated renal function during remdesivir. Fourteen patients in the elderly cohort deceased; their eGFR at baseline was significantly lower. Recovered patients were characterized by a relevant eGFR gaining during remdesivir treatment.Conclusion: We show here for the first time as remdesivir does not influence eGFR in a cohort of elderly people hospitalized for SARS CoV2, and that eGFR gain during such treatment is coupled with a better prognosis.Keywords: remdesivir, SARS CoV2, glomerular filtration rate, aging, chronic kidney disease
