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Acute Kidney Injury in Covid-19 Patients Receiving Remdesivir: A Systematic Review and Meta-Analysis of Randomized Clinical Trials Publisher Pubmed



Shams G1 ; Kazemi A2 ; Jafaryan K3 ; Morowvat MH1 ; Peymani P4 ; Karimzadeh I5
Authors
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Authors Affiliations
  1. 1. Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  2. 2. Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  3. 3. Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. College of Pharmacy, University of Manitoba, Winnipeg, MB, Canada
  5. 5. Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran

Source: Clinics Published:2023


Abstract

Objectives: Remdesivir is an antiviral agent with positive effects on the prognosis of Coronavirus Disease (COVID-19). However, there are concerns about the detrimental effects of remdesivir on kidney function which might consequently lead to Acute Kidney Injury (AKI). In this study, we aim to determine whether remdesivir use in COVID-19 patients increases the risk of AKI. Methods: PubMed, Scopus, Web of Science, the Cochrane Central Register of Controlled Trials, medRxiv, and bioRxiv were systematically searched until July 2022, to find Randomized Clinical Trials (RCT) that evaluated remdesivir for its effect on COVID-19 and provided information on AKI events. A random-effects model meta-analysis was conducted and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation. The primary outcomes were AKI as a Serious Adverse Event (SAE) and combined serious and non-serious Adverse Events (AE) due to AKI. Results: This study included 5 RCTs involving 3095 patients. Remdesivir treatment was not associated with a significant change in the risk of AKI classified as SAE (Risk Ratio [RR]: 0.71, 95% Confidence Interval [95% CI] 0.43‒1.18, p = 0.19, low-certainty evidence) and AKI classified as any grade AEs (RR = 0.83, 95% CI 0.52‒1.33, p = 0.44, low-certainty evidence), compared to the control group. Conclusion: Our study suggested that remdesivir treatment probably has little or no effect on the risk of AKI in COVID-19 patients. © 2023 HCFMUSP
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