Publication details

The impact of remdesivir on renal and liver functions in severe COVID-19 patients with presence of viral load

Authors	WALDAUF Petr JURISINOVA Ivana SVOBODOVA Eva DIBLICKOVA Michaela TENCER Tomas ZAVORA Jan SMELA Gabriela KUPIDLOVSKA Lenka ADAMKOVA Vaclava FRIDRICHOVA Marta JERABKOVA Karolina MIKES Jakub DUSKA Frantisek DUŠEK Ladislav BALIK Martin
Year of publication	2025
Type	Article in Periodical
Magazine / Source	Scientific Reports
MU Faculty or unit	Faculty of Medicine
Citation
web	https://www.nature.com/articles/s41598-025-05541-9
Doi	https://doi.org/10.1038/s41598-025-05541-9
Keywords	Remdesivir; SARS-CoV-2; Viral load; Renal function; Liver function tests; Intensive care
Description	The impact of remdesivir on renal and liver functions remains a matter of concern in advanced COVID-19 patients with high illness severity and presence of viral load. The laboratory results of the 114 patients (males 55.8%, age 71 (59; 77) years) with a detectable viral load treated with remdesivir were compared with the controls. Baseline plasmatic creatinine (PCr) < 150 mol/l in patients on remdesivir decreased equally to controls (- 6 (- 20; 9) vs. - 8 (- 24; 2) mu mol/l, n = 170, p = 0.11). The similar trends were found for baseline PCr >= 150 mu mol/l (- 57 (- 129; - 15) mu mol/l for remdesivir group vs. - 65 (- 111; - 7) mu mol/l, p > 0.9). Changes of PCr were independent of the remdesivir therapy, the statistically significant confounders were baseline PCr levels (p < 0.001), hospital length-of-stay (p < 0.001), leukocyte-to-lymphocyte ratio (p = 0.025). The plasmatic urea (PU) mildly increased in the remdesivir group (1 (- 2; 5) mmol/l vs. 0 (- 3; 2) mmol/l in the controls, p = 0.009), its levels were related to remdesivir (p = 0.026), age (p = 0.002), PCr (p < 0.001), hospital length-of-stay (p < 0.001), IPPV (p = 0.035). Regarding the liver function tests the significant relationships to remdesivir therapy were found only for GGT (p = 0.007) and ALT (p = 0.044). The levels of PCr were decreasing over the hospitalisation period including patients with mild-to-moderate renal insufficiency. The multivariate regression analysis excluded an impact of remdesivir on the PCr changes yet admitted an impact on the levels of urea, GGT and ALT.