Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain.
Departamento de Nefrología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain.
Nefrologia (Engl Ed). 2022 May-Jun;42(3):311-317. doi: 10.1016/j.nefroe.2022.07.006. Epub 2022 Aug 2.
Remdesivir is the only antiviral treatment that has been shown to be useful against SARS-CoV-2 infection. It shorts hospitalization time compared to placebo. Its effects in Kidney transplant (KT) patients are limited to some published cases.
We performed a retrospective observational study that included all KT patients admitted between August 01, 2020 and December 31, 2020 with SARS-CoV-2 pneumonia who received remdesivir. The objective of this study was to describe the experience of a cohort of KT patients treated with remdesivir.
A total of 37 KT patients developed SARS-CoV-2 infection, 7 of them received treatment with remdesivir. The rest of the patients did not receive the drug due to either CKD-EPI less than 30 mL/min or they did not present clinical criteria. In addition to remdesivir, all pacients received dexamethasone and anticoagulation therapy. 4 were men, the median age was 59 (53-71) years. Median time from transplantation was 43 (16-82) months. Chest X-rays of all patients showed pulmonary infiltrates and required low oxygen flow therapy upon admission, requiring high flow nasal therapy in 3 cases. Only 2 cases presented deterioration of the graft function, not requiring hemodialysis in any case, and all recovered renal function at hospital discharge. 2 patients rise up 1.5 times the liver function test. No patient died or required admission to the critical care unit. Median days of admission was 12 (9-27) days.
Our study suggests that the use of remdesivir could be useful in KT patients with SARS-CoV-2 pneumonia without side effects. Additional studies are necessary with a larger number of patients to improve the knowledge of this drug in SARS-CoV-2 infection.
瑞德西韦是唯一被证明对 SARS-CoV-2 感染有效的抗病毒治疗药物。与安慰剂相比，它缩短了住院时间。其在肾移植（KT）患者中的作用仅限于一些已发表的病例。
我们进行了一项回顾性观察性研究，纳入了 2020 年 8 月 1 日至 2020 年 12 月 31 日期间因 SARS-CoV-2 肺炎住院并接受瑞德西韦治疗的所有 KT 患者。本研究的目的是描述一组接受瑞德西韦治疗的 KT 患者的经验。
共有 37 例 KT 患者发生 SARS-CoV-2 感染，其中 7 例接受瑞德西韦治疗。其余患者因 CKD-EPI 低于 30 mL/min 或未出现临床标准而未接受该药物治疗。除瑞德西韦外，所有患者均接受地塞米松和抗凝治疗。4 例为男性，中位年龄为 59（53-71）岁。中位移植时间为 43（16-82）个月。所有患者的胸部 X 线片均显示肺部浸润，入院时需要低氧流量治疗，3 例需要高流量鼻治疗。仅 2 例出现移植物功能恶化，均无需血液透析，所有患者在出院时肾功能均恢复。2 例患者肝功能试验升高 1.5 倍。无患者死亡或需要入住重症监护病房。中位住院天数为 12（9-27）天。
我们的研究表明，瑞德西韦可用于 SARS-CoV-2 肺炎的 KT 患者，且无副作用。需要进行更多的研究，以增加患者数量，提高对该药物在 SARS-CoV-2 感染中的认识。
