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Kidney Week

Abstract: TH-PO1094

Effect of Remdesivir on Long-Term Adverse Cardiac and Kidney Outcomes in Patients with COVID-19 and Impaired Kidney Function

Session Information

  • COVID-19 - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Wang, Qiyu, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Dinulos, James, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Cosar, Duru E., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Strohbehn, Ian Austin, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Zhao, Sophia, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Sise, Meghan E., Massachusetts General Hospital, Boston, Massachusetts, United States
Background

Patients (pts) who survive COVID-19 are at increased risk for cardiac and kidney sequelae. We sought to determine if the use of remdesivir in pts with underlying kidney impairment who were hospitalized for COVID-19 is associated with differences in long-term cardiac and kidney adverse outcomes.

Methods

We performed a propensity-score matched cohort study to compare the risk of major adverse cardiovascular events (MACE), major adverse kidney event (MAKE), slope of eGFR decline among pts hospitalized for COVID-19 with admission eGFR<60mL/min who received remdesivir versus historical comparators admitted prior to EUA for remdesivir (Figure 1). Among pts surviving 30 days and followed up to 18 months, we used Cox proportional hazards model to predict risk of hospitalization/death from MACE and MAKE; we used mixed effect linear model to estimate the eGFR decline slope.

Results

Among the 412 pts who survived >30 days (N=162 for remdesivir-treated cohort, N=250 for historical comparators, variable matching used, Figure1), mean age was 71(SD13), 55% were male, 18% were black, 11% required mechanical ventilation and mean admission creatinine was 1.5mg/dL (1.3 – 2.0). By 18 months, there was no significant difference in MACE or MAKE between the two groups. However, remdesivir use was associated with a significant attenuation of eGFR decline between 30 days to 18 months (-0.77 vs. -2.81 mL/min/year) (Table1).

Conclusion

Among pts with underlying kidney impairment hospitalized for COVID-19 who survived >30 days, remdesivir use was not associated with reduction of MACE or MAKE. However, there was attenuation of eGFR decline in pts treated with remdesivir.

Funding

  • Commercial Support – Gilead Science