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

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

Abstract 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 re...

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Main Authors: Petr Waldauf, Ivana Jurisinova, Eva Svobodova, Michaela Diblickova, Tomas Tencer, Jan Zavora, Gabriela Smela, Lenka Kupidlovska, Vaclava Adamkova, Marta Fridrichova, Karolina Jerabkova, Jakub Mikes, Frantisek Duska, Ladislav Dusek, Martin Balik
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Subjects:
Remdesivir
SARS-CoV-2
Viral load
Renal function
Liver function tests
Intensive care
Online Access:https://doi.org/10.1038/s41598-025-05541-9
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Summary:Abstract 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 µmol/l in patients on remdesivir decreased equally to controls (− 6 (− 20; 9) vs. − 8 (− 24; 2) µmol/l, n = 170, p = 0.11). The similar trends were found for baseline PCr ≥ 150 µmol/l (− 57 (− 129; − 15) µmol/l for remdesivir group vs. − 65 (− 111; − 7) µmol/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.
ISSN:2045-2322

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