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10.1128/AAC.02290-20

http://scihub22266oqcxt.onion/10.1128/AAC.02290-20
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33229428!7849020!33229428
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suck abstract from ncbi


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pmid33229428      Antimicrob+Agents+Chemother 2021 ; 65 (2): ä
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  • A Valid Warning or Clinical Lore: an Evaluation of Safety Outcomes of Remdesivir in Patients with Impaired Renal Function from a Multicenter Matched Cohort #MMPMID33229428
  • Ackley TW; McManus D; Topal JE; Cicali B; Shah S
  • Antimicrob Agents Chemother 2021[Jan]; 65 (2): ä PMID33229428show ga
  • Per prescribing guidance, remdesivir is not recommended for SARS-CoV-2 in patients with renal disease given the absence of safety data in this patient population. This study was a multicenter, retrospective chart review of hospitalized patients with SARS-CoV-2 who received remdesivir. Safety outcomes were compared between patients with an estimated creatinine clearance (eCrCl) of <30 ml/min and an eCrCl of >/=30 ml/min. The primary endpoint was acute kidney injury (AKI) at the end of treatment (EOT). Of 359 patients who received remdesivir, 347 met inclusion criteria. Patients with an eCrCl of <30 ml/min were older median, 80 years (interquartile range [IQR], 63.8 to 89) versus 62 (IQR, 54 to 74); P < 0.001, were more likely to be on vasopressors on the day of remdesivir administration (30% versus 12.7%; P = 0.003), and were more likely to be mechanically ventilated during remdesivir therapy (27.5% versus 12.4%; P = 0.01) than those with an eCrCl of >/=30 ml/min. Despite these confounders, there was no significant difference in the frequency of EOT AKI (5% versus 2.3%; P = 0.283) or early discontinuation due to abnormal liver function tests (LFTs) (0% versus 3.9%; P = 0.374). Of the 5% of patients who developed EOT AKI on remdesivir with an eCrCl <30 ml/min, no cases were attributable to remdesivir administration per the treating physician. Comparable safety outcomes were observed when 1:1 nearest neighbor matching was applied to account for baseline confounders. In conclusion, remdesivir administration was not significantly associated with increased EOT AKI in patients with an eCrCl of <30 ml/min compared to patients with an eCrCl of >/=30 ml/min.
  • |*COVID-19 Drug Treatment[MESH]
  • |Adenosine Monophosphate/administration & dosage/*analogs & derivatives[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Alanine/administration & dosage/*analogs & derivatives[MESH]
  • |Antiviral Agents/*administration & dosage[MESH]
  • |COVID-19/physiopathology/virology[MESH]
  • |Cohort Studies[MESH]
  • |Creatinine/metabolism[MESH]
  • |Humans[MESH]
  • |Kidney Function Tests[MESH]
  • |Kidney/physiopathology[MESH]
  • |Middle Aged[MESH]
  • |Renal Insufficiency/*drug therapy/physiopathology/virology[MESH]
  • |Retrospective Studies[MESH]


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