Acute kidney injury in COVID-19 patients receiving remdesivir: A systematic review and meta-analysis of randomized clinical trials

Authors

  • Golnaz Shams Shiraz University of Medical Sciences
  • Asma Kazemi Shiraz University of Medical Sciences
  • Khatereh Jafaryan Isfahan University of Medical Sciences
  • Mohammad Hossein Morowvat Shiraz University of Medical Sciences
  • Payam Peymani University of Manitoba
  • Iman Karimzadeh Shiraz University of Medical Sciences https://orcid.org/0000-0003-0777-8088

DOI:

https://doi.org/10.1016/j.clinsp.2023.100200

Keywords:

SARS-COV-2, COVID-19, Acute Kidney Injury, Remdesivir, Systematic review, Meta-analysis

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.

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Published

2023-04-13

Issue

Section

Review Articles

How to Cite

Shams, G., Kazemi, A., Jafaryan, K., Morowvat, M. H., Peymani, P., & Karimzadeh, I. (2023). Acute kidney injury in COVID-19 patients receiving remdesivir: A systematic review and meta-analysis of randomized clinical trials. Clinics, 78, 100200. https://doi.org/10.1016/j.clinsp.2023.100200