Arias-Cabrales, C. (Carlos)

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    Use and safety of remdesivir in kidney transplant recipients with COVID-19
    (Elsevier, 2021) Buxeda, A. (Anna); Arias-Cabrales, C. (Carlos); Pérez-Sáez, M.J. (María José); Cacho, J. (Judit); Cabello-Pelegrin, S. (Sheila); Melilli, E. (Edoardo); Aladrén, M.J. (María José); Galeano, C. (Cristina); Lorenzo, I. (Inmaculada); Mazuecos, M.A. (María Auxiliadora); Saura, I.M. (Isabel María); Franco, A. (Antonio); Ruiz-Fuentes, M.C. (María C.); Sánchez-Cámara, L.A. (Luis A.); Siverio, O. (Orlando); Martin-Ramos, M.L. (Maria Luisa); González-Blanco-García, E. (Elena); López, V. (Verónica); Martín-Moreno, P.L. (Paloma L.); Moina, I. (Iñigo); Moral-Berrio, E. (Esperanza); Moreso, F. (Francesc); Portolés-Lázaro, J. (José); Santana-Estupiñán, R. (Raquel); Zárraga, S. (Sofía); Canal, C. (Cristina); Sánchez-Álvarez, E. (Emilio); Pascual, J. (Julio); Crespo, M. (Marta)
    Introduction: Remdesivir has demonstrated antiviral activity against coronavirus, shortening the time to recovery in adults hospitalized with moderate/severe COVID-19. Severe adverse events such as acute kidney injury have been reported. Scant data are available on the use and safety of remdesivir in kidney transplant recipients. Methods: We present a multicenter cohort study of 51 kidney transplant recipients with COVID-19 treated with remdesivir. Outcomes and safety were assessed. Results: Mean age at diagnosis was 60 years, with a median time since kidney transplant of 4.5 years. Mean time since admission to remdesivir was 2 days. Twenty-eight patients (54.9%) required mechanical ventilation (19 noninvasive). Mortality was 18.9% and markedly higher if aged ≥65 years (45% vs. 3.2% in younger patients). Acute kidney injury was present in 27.7% of patients, but was diagnosed in 50% before treatment. No patients required remdesivir discontinuation because of adverse events. We did not find significant hepatoxicity or systemic symptoms resulting from the drug. Conclusion: In our cohort of kidney transplant recipients, remdesivir was well tolerated and safe in renal and hepatic toxicity, but randomized trials are needed to assess its efficacy.