Aleem Abdul, Mahadevaiah Guruprasad, Shariff Nasir, Kothadia Jiten P
Gastroenterology and Hepatology, Lehigh Valley Health Network, Allentown, Pennsylvania.
Cardiology, California Northstate University College of Medicine, Sacramento, California.
Proc (Bayl Univ Med Cent). 2021 Mar 8;34(4):473-477. doi: 10.1080/08998280.2021.1885289.
COVID-19 has emerged as a major global health crisis since the first cases were reported in China in December 2019. Remdesivir is the only broad-spectrum antiviral approved by the US Food and Drug Administration to treat hospitalized patients with COVID-19 infection. Although the adverse effects of remdesivir are largely unknown, data from randomized controlled trials have demonstrated its deleterious effect on the liver. This review briefly addresses the hepatic manifestations of COVID-19 infection and the data regarding the efficacy and adverse effects of remdesivir on liver function when used in patients hospitalized with COVID-19. Through a literature search, we identified five randomized controlled trials, two case reports, and one case series, including a total of 2375 patients. Although mild transaminase elevation has been reported as a feature of COVID-19, there has been a concern of hepatotoxicity associated with the use of remdesivir. Based on the limited available data regarding the adverse effects of remdesivir on hepatic function, it is prudent to exercise caution by evaluating baseline liver function, avoiding the use of potentially hepatotoxic drugs, and closely monitoring liver function when using remdesivir in patients hospitalized with COVID-19.
自2019年12月中国报告首例病例以来，新型冠状病毒肺炎（COVID-19）已成为全球重大公共卫生危机。瑞德西韦是美国食品药品监督管理局批准的唯一一种用于治疗COVID-19感染住院患者的广谱抗病毒药物。尽管瑞德西韦的不良反应大多未知，但随机对照试验的数据已证明其对肝脏有有害作用。本综述简要阐述了COVID-19感染的肝脏表现以及瑞德西韦用于COVID-19住院患者时对肝功能的疗效和不良反应数据。通过文献检索，我们确定了五项随机对照试验、两篇病例报告和一篇病例系列研究，共纳入2375例患者。虽然已有报道称轻度转氨酶升高是COVID-19的一个特征，但人们一直担心使用瑞德西韦会导致肝毒性。基于瑞德西韦对肝功能不良反应的现有有限数据，在对COVID-19住院患者使用瑞德西韦时，通过评估基线肝功能、避免使用潜在肝毒性药物并密切监测肝功能来谨慎行事是明智的。
