Division of Infectious Diseases, Department of Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan.
Department of Pharmacy, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan.
J Paediatr Child Health. 2024 Jul;60(7):299-302. doi: 10.1111/jpc.16569. Epub 2024 May 31.
Remdesivir (RDV) causes liver enzyme elevation in adults; however, the frequency of this elevation in children and the associated risk factors are largely unknown. Therefore, we aimed to examine risk factors for liver enzyme elevation in hospitalised paediatric patients who received RDV.
This was a retrospective case-control study of all patients aged <18 years who were diagnosed with coronavirus disease 2019 and received RDV at a tertiary care hospital between February 2022 and September 2023. Demographic and clinical data were retrieved from the medical records and analysed. Patients with liver enzyme elevation were defined as cases, while those with no liver enzyme elevation were defined as controls. The two groups were compared and analysed for possible risk factors for liver enzyme elevation with RDV use.
Sixty-six patients were treated with RDV, 12 (18.2%) of whom developed liver enzyme elevation. Liver enzyme elevation was associated with the median duration of RDV administration (7.5 days vs. 3 days, P = 0.012), median total RDV dose (17.7 mg/kg vs. 10.3 mg/kg, P = 0.017) and acetaminophen use (67% vs. 22%) (odds ratio = 4.34; 95% confidence interval, 1.05-19.97, P = 0.023). All patients showed improvement, except three who had no liver enzyme measurements after having the highest aspartate aminotransferase and alanine aminotransferase values during the observation period.
Liver enzyme elevation was reversible after discontinuing RDV use. Overall, RDV can be considered safe in children with careful monitoring.
瑞德西韦（RDV）会导致成年人肝酶升高；然而，儿童中这种升高的频率以及相关的危险因素在很大程度上尚不清楚。因此，我们旨在研究接受 RDV 治疗的住院儿科患者肝酶升高的危险因素。
这是一项回顾性病例对照研究，纳入了 2022 年 2 月至 2023 年 9 月期间在一家三级护理医院被诊断为 2019 年冠状病毒病并接受 RDV 治疗的所有<18 岁的患者。从病历中检索人口统计学和临床数据并进行分析。肝酶升高的患者定义为病例，而无肝酶升高的患者定义为对照。比较两组患者，分析与 RDV 使用相关的肝酶升高的可能危险因素。
共有 66 例患者接受了 RDV 治疗，其中 12 例（18.2%）出现肝酶升高。肝酶升高与 RDV 治疗的中位持续时间（7.5 天 vs. 3 天，P=0.012）、中位总 RDV 剂量（17.7mg/kg vs. 10.3mg/kg，P=0.017）和使用对乙酰氨基酚（67% vs. 22%）相关（比值比=4.34；95%置信区间，1.05-19.97，P=0.023）。所有患者均有改善，除了 3 例患者在观察期间出现最高天门冬氨酸氨基转移酶和丙氨酸氨基转移酶值后没有进行肝酶测量。
停止使用 RDV 后肝酶升高是可逆的。总体而言，在密切监测下，RDV 可被认为在儿童中是安全的。
