Department of Infectious Diseases, National Hospital Organization Kyoto Medical Center, 1-1 Fukakusa-Mukaihata-Cho, Fushimi-Ku, Kyoto, Japan.
Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
Drugs Aging. 2021 Dec;38(12):1067-1074. doi: 10.1007/s40266-021-00908-9. Epub 2021 Dec 2.
Although older patients with coronavirus disease 2019 (COVID-19) are at the high risk of exacerbation that requires treatment with remdesivir, the safety of this medication is unclear in clinical practice, especially among older patients. We aimed to retrospectively evaluate the safety of remdesivir in older patients with COVID-19 who required hospitalization in our institute.
We reviewed patients with COVID-19 who were treated with remdesivir at our institute between July 2020 and May 2021. We defined older patients as those aged 80 years or older at admission; all other patients were defined as younger patients. We evaluated the safety of remdesivir by examining the incidence of discontinuation of remdesivir treatment because of adverse events and the incidence of any adverse events.
A total of 80 patients were included in this study. Compared with younger patients, fewer older patients were treated with remdesivir for more than 5 days: 4 (15.4%) vs 23 (42.6%). Discontinuation of remdesivir because of adverse events occurred in one older patient (3.9%) and four younger patients (7.4%) [p > 0.99]. Remdesivir-induced liver dysfunction was the most frequent adverse event, which occurred in 29 (36.3%) patients. There were no significant differences in the incidence of remdesivir-induced liver dysfunction, renal dysfunction, and fatigue.
The safety of remdesivir was suggested to be comparable between patients older than 80 years of age and patients younger than 80 years of age. The results of this study may encourage the administration of remdesivir to this older patient group.
虽然患有 2019 年冠状病毒病(COVID-19)的老年患者病情恶化的风险较高,需要用瑞德西韦进行治疗,但该药在临床实践中的安全性尚不清楚,尤其是在老年患者中。我们旨在回顾性评估瑞德西韦在我院需要住院治疗的 COVID-19 老年患者中的安全性。
我们回顾了 2020 年 7 月至 2021 年 5 月期间在我院接受瑞德西韦治疗的 COVID-19 患者。我们将年龄在 80 岁及以上的患者定义为入院时年龄较大的患者;所有其他患者定义为年龄较小的患者。我们通过检查因不良事件而停止瑞德西韦治疗的发生率和任何不良事件的发生率来评估瑞德西韦的安全性。
本研究共纳入 80 例患者。与年轻患者相比,接受瑞德西韦治疗超过 5 天的老年患者较少:4 例(15.4%)比 23 例(42.6%)。因不良事件而停止瑞德西韦治疗的患者中,1 例(3.9%)为老年患者,4 例(7.4%)为年轻患者(p>0.99)。瑞德西韦引起的肝功能障碍是最常见的不良事件,共发生 29 例(36.3%)。瑞德西韦引起的肝肾功能障碍和疲劳的发生率无显著差异。
80 岁以上患者与 80 岁以下患者使用瑞德西韦的安全性相当。本研究结果可能鼓励对这一年龄较大的患者群体使用瑞德西韦。