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
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Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-05541-9
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author 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
author_facet 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
author_sort Petr Waldauf
collection DOAJ
description 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.
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spelling doaj-art-24e2e4e690894f56aab3d01e6b83df492025-08-20T03:45:23ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-05541-9The impact of remdesivir on renal and liver functions in severe COVID-19 patients with presence of viral loadPetr Waldauf0Ivana Jurisinova1Eva Svobodova2Michaela Diblickova3Tomas Tencer4Jan Zavora5Gabriela Smela6Lenka Kupidlovska7Vaclava Adamkova8Marta Fridrichova9Karolina Jerabkova10Jakub Mikes11Frantisek Duska12Ladislav Dusek13Martin Balik14Department of Anaesthesiology and Intensive Care, 3rd Faculty of Medicine, Charles University and Kralovske Vinohrady University HospitalDepartment of Anaesthesiology and Intensive Care, 1st Faculty of Medicine, Charles University and General University HospitalDepartment of Anaesthesiology and Intensive Care, 1st Faculty of Medicine, Charles University and General University HospitalDepartment of Anaesthesiology and Intensive Care, 1st Faculty of Medicine, Charles University and General University HospitalDepartment of Anaesthesiology and Intensive Care, 3rd Faculty of Medicine, Charles University and Kralovske Vinohrady University HospitalInstitute of Medical Biochemistry and Laboratory Diagnostics, 1st Faculty of Medicine, Charles University and General University HospitalInstitute of Medical Biochemistry and Laboratory Diagnostics, 1st Faculty of Medicine, Charles University and General University HospitalInstitute of Medical Biochemistry and Laboratory Diagnostics, 1st Faculty of Medicine, Charles University and General University HospitalInstitute of Medical Biochemistry and Laboratory Diagnostics, 1st Faculty of Medicine, Charles University and General University HospitalDepartment of Laboratory Diagnostics, 3rd Faculty of Medicine, Charles University and Kralovske Vinohrady University HospitalDepartment of Anaesthesiology and Intensive Care, 3rd Faculty of Medicine, Charles University and Kralovske Vinohrady University HospitalDepartment of Anaesthesiology and Intensive Care, 3rd Faculty of Medicine, Charles University and Kralovske Vinohrady University HospitalDepartment of Anaesthesiology and Intensive Care, 3rd Faculty of Medicine, Charles University and Kralovske Vinohrady University HospitalInstitute of Health Information and Statistics of the Czech Republic, Faculty of Medicine, Masaryk UniversityDepartment of Anaesthesiology and Intensive Care, 1st Faculty of Medicine, Charles University and General University HospitalAbstract 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.https://doi.org/10.1038/s41598-025-05541-9RemdesivirSARS-CoV-2Viral loadRenal functionLiver function testsIntensive care
spellingShingle 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
The impact of remdesivir on renal and liver functions in severe COVID-19 patients with presence of viral load
Scientific Reports
Remdesivir
SARS-CoV-2
Viral load
Renal function
Liver function tests
Intensive care
title The impact of remdesivir on renal and liver functions in severe COVID-19 patients with presence of viral load
title_full The impact of remdesivir on renal and liver functions in severe COVID-19 patients with presence of viral load
title_fullStr The impact of remdesivir on renal and liver functions in severe COVID-19 patients with presence of viral load
title_full_unstemmed The impact of remdesivir on renal and liver functions in severe COVID-19 patients with presence of viral load
title_short The impact of remdesivir on renal and liver functions in severe COVID-19 patients with presence of viral load
title_sort impact of remdesivir on renal and liver functions in severe covid 19 patients with presence of viral load
topic Remdesivir
SARS-CoV-2
Viral load
Renal function
Liver function tests
Intensive care
url https://doi.org/10.1038/s41598-025-05541-9
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