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Case Report: Severe SARS-CoV-2 Infection Treated with Remdesivir in a Patient with ESRD

Raj H Patel1, Pablo M Pella2, Naeem Haider3

  • 1Edward Via College of Osteopathic Medicine, Monroe, LA, USA.

Infectious Disorders Drug Targets
|December 2, 2021
PubMed

Insights

This case study shows successful treatment of COVID-19 in an End-Stage Renal Disease patient using remdesivir. Despite severe kidney impairment, the patient showed symptom improvement after antiviral therapy.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • COVID-19 pandemic presents challenges in managing patients with End-Stage Renal Disease (ESRD).
  • ESRD patients face higher risks for severe COVID-19 due to comorbidities.
  • Limited data exists on remdesivir efficacy and safety in severe renal impairment due to exclusion from trials.

Observation:

  • A 47-year-old male with ESRD and COVID-19 experienced worsening respiratory failure despite intensive care.
  • Remdesivir was administered after risk-benefit analysis, despite an estimated glomerular filtration rate (eGFR) <15 ml/min per 1.73m².
  • The patient developed reversible hepatotoxicity during treatment.

Findings:

  • Successful treatment of COVID-19 in an ESRD patient with remdesivir.
  • Marked symptom improvement observed post-five-day remdesivir course.
  • Compassionate use of remdesivir demonstrated clinical benefit in a complex patient.

Implications:

  • Suggests potential for remdesivir use in select ESRD patients with COVID-19 under careful monitoring.
  • Highlights the need for further research into antiviral management for renal impairment patients.
  • Provides evidence for compassionate use protocols in critical COVID-19 cases with comorbidities.
Abstract

Keywords:
ARDSCOVID-19ESRDacute kidney injurychronic kidney diseasehemodialysisremdesivir

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