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Kidney Week

Abstract: FR-PO1135

Association of Renal Function with Mortality Among Hospitalized Patients Treated with Remdesivir for COVID-19

Session Information

  • COVID-19 - II
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Gonzalez Suarez, Maria Lourdes, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Mara, Kristin C., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Rivera, Christina, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Chesdachai, Supavit, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Draper, Evan, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Razonable, Raymund, Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background

Renal dysfunction is associated with poor outcomes in patients with coronavirus disease 2019 (COVID-19). In an effort to improve outcomes, intravenous remdesivir has been broadly used off label for the treatment of COVID-19 in patients with low estimated glomerular filtration rate (eGFR). Our study assessed the outcomes of patients with low eGFR after treatment with remdesivir for COVID-19.

Methods

We conducted an observational, retrospective, cohort study of adults hospitalized with COVID-19 treated with at least one dose of remdesivir between 11/6/2020, and 11/5/2021. Electronic medical records were reviewed to obtain patient characteristics, laboratory data, and outcomes. Primary endpoint was all-cause mortality by day 28. Multivariable logistic regression was used to evaluate association among groups.

Results

We studied 3024 patients hospitalized with COVID-19 and treated with remdesivir. Median age was 67 [IQR 55, 77] years; 42.7% were women, 88.6% were white. Median eGFR was 76.6 mL/min/1.73 m2 [IQR 52.5, 95.2]; 67.2% of patients had eGFR ≥ 60, while 9% had eGFR <30. All-cause mortality by day 28 was 8.7%. All-cause mortality rates were significantly higher among patients with impaired renal function (Odds Ratio [OR] 1.94 for patients with eGFR 30-59; OR 1.94 for eGFR 15-29; OR 3.62 for eGFR <15 and OR 9.08 for patients on dialysis) compared to patients with eGFR ≥60 (all p<0.01) (Figure 1).

Conclusion

Lower eGFR is an independent risk factor for mortality in COVID-19 despite treatment with remdesivir. These observations suggest that, even with the availability of effective antiviral treatment, prevention of COVID-19 remains a major goal especially among those with impaired renal function.

Overall survival according to eGFR

Funding

  • Commercial Support – Gilead