Wong Yi-Ching, Ng Chip-Jin, Huang Yan-Bo, Chen Shou-Yen
Department of Emergency Medicine, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Graduate Institute of Management, College of Management, Chang Gung University, Taoyuan 333, Taiwan.
Life (Basel). 2025 Mar 21;15(4):512. doi: 10.3390/life15040512.
Patients with liver cirrhosis are at an increased risk of mortality from coronavirus disease 2019 (COVID-19). Remdesivir, an adenosine analog, exhibits activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is thus recommended for inpatients with COVID-19. This study evaluated the effectiveness and safety of remdesivir in patients with COVID-19 and liver cirrhosis.
This retrospective study was conducted using data from Taiwan's largest healthcare system. The study cohort comprised adult patients with COVID-19 and liver cirrhosis who visited our emergency department between April 2021 and September 2022. Remdesivir's adverse effects, including bradycardia, anemia, unstable glucose levels, and abnormal liver function test results, were recorded. Treatment outcomes were assessed in terms of hospitalization duration, mortality, intubation, and intensive care unit admission.
This study included 1368 patients with COVID-19 and liver cirrhosis, of whom 46 received remdesivir. Remdesivir recipients were older (66.5 vs. 62 years; = 0.042) and had a higher rate of oxygen therapy use (56.52% vs. 32.22%; = 0.001) than nonrecipients. Common adverse effects of remdesivir included lower heart rates (83 vs. 96 bpm; < 0.001) and decreased hemoglobin levels (9.5 vs. 10.2 g/dL; = 0.003) without fatal consequences. No statistically significant difference between remdesivir recipients and nonrecipients in hospitalization duration, intubation rates, or mortality rates was found.
Remdesivir is safe for treating COVID-19 in patients with liver cirrhosis. Although remdesivir recipients exhibited trends toward improved outcomes in our study, large-scale studies are required to confirm its efficacy in this population.
肝硬化患者因2019冠状病毒病（COVID-19）死亡的风险增加。瑞德西韦是一种腺苷类似物，对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）具有活性，因此被推荐用于COVID-19住院患者。本研究评估了瑞德西韦在COVID-19合并肝硬化患者中的有效性和安全性。
本回顾性研究使用了台湾最大医疗系统的数据。研究队列包括2021年4月至2022年9月期间到我们急诊科就诊的COVID-19合并肝硬化成年患者。记录瑞德西韦的不良反应，包括心动过缓、贫血、血糖水平不稳定和肝功能检查结果异常。根据住院时间、死亡率、插管率和重症监护病房入住情况评估治疗结果。
本研究纳入了1368例COVID-19合并肝硬化患者，其中46例接受了瑞德西韦治疗。接受瑞德西韦治疗的患者比未接受治疗的患者年龄更大（66.5岁对62岁；P = 0.042），且使用氧疗的比例更高（56.52%对32.22%；P = 0.001）。瑞德西韦的常见不良反应包括心率降低（83次/分钟对96次/分钟；P < 0.001）和血红蛋白水平下降（9.5 g/dL对10.2 g/dL；P = 0.003），但无致命后果。在住院时间、插管率或死亡率方面，接受瑞德西韦治疗的患者与未接受治疗的患者之间未发现统计学显著差异。
瑞德西韦用于治疗肝硬化合并COVID-19患者是安全的。尽管在我们的研究中接受瑞德西韦治疗的患者有预后改善的趋势，但仍需要大规模研究来证实其在该人群中的疗效。
