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

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Remdesivir has emerged as a promising antiviral drug against SARS-CoV-2. However, data regarding the clinical benefits of remdesivir in patients with severe renal impairment is unavailable as they have been excluded from clinical trials due to the risk of sulfobutylether-β-cyclodextrin (SBECD) accumulation in patients with eGFR<30 ml/min per 1.73m2.

Here it is presented the first case of a 47-year-old male with end-stage renal disease who was successfully treated with remdesivir during hospitalization for acute respiratory distress syndrome and respiratory failure arising from COVID-19. The worsening clinical progress of the patient despite intensive care and treatment with intravenous azithromycin therapy led to the decision to utilize remdesivir after a risk-benefit analysis, despite his eGFR being <15 ml/min per 1.73m2. Although the patient developed reversible hepatotoxicity, marked improvement of symptoms was observed after the five-day course of remdesivir was completed.

Patel RH, Pella PM, Haider N, Blanco R. Case Report: Severe SARS-CoV-2 Infection Treated with Remdesivir in a Patient with ESRD. Infect Disord Drug Targets. 2022;22(3):e011221198456. doi: 10.2174/1871526521666211201112410.

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