Safety of remdesivir in the treatment of acute SARS-CoV-2 infection in pediatric patients. BMC Infect Dis 2024 Sep 17;24(1):987
Date
09/18/2024Pubmed ID
39289614Pubmed Central ID
PMC11406769DOI
10.1186/s12879-024-09833-9Scopus ID
2-s2.0-85204305720 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
BACKGROUND: Transaminase and creatinine elevations have been well described in adults treated with remdesivir for COVID-19. It is hypothesized that a similar safety profile exists in children with COVID-19 treated with remdesivir, but available data are limited, especially in children < 12 months. The primary aim of this study was to determine the prevalence and timing of elevations in transaminases and creatinine in children with COVID-19 who were treated with remdesivir.
METHODS: This was a retrospective, observational cohort study including all pediatric patients admitted to a single, freestanding children's hospital who were positive for COVID-19 and received at least 1 dose of remdesivir between 1/1/2020 and 5/31/2022. Available baseline and peak transaminase and creatinine concentrations were evaluated. Multivariable logistic regression analysis was performed to identify risk factors for transaminase elevation.
RESULTS: A total of 180 patients met inclusion criteria. Creatinine elevation of any grade was noted in 16% and remained elevated only in those with underlying chronic kidney disease. Transaminase elevation of any grade was noted in 58% of patients and remained elevated in only 1%. Older age and critical respiratory disease were associated with higher risk of significant transaminase elevation, whereas non-Hispanic ethnicity was strongly associated with protection against significant transaminase elevation.
CONCLUSIONS: In our cohort of hospitalized children with COVID-19 who were treated with remdesivir, most patients experienced only mild transaminitis and normal creatinine concentrations. A limited number of patients experienced laboratory abnormalities which were transient, suggesting a favorable safety profile for remdesivir use in pediatrics.
Author List
Player B, Huppler AR, Pan AY, Liegl M, Havens PL, Ray K, Mitchell M, Graff KAuthors
Kelly E. Graff MD Assistant Professor in the Pediatrics department at Medical College of WisconsinAnna Huppler MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Michelle Mitchell MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Amy Y. Pan PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Brittany Player DO Assistant Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Adenosine MonophosphateAdolescent
Alanine
Alanine Transaminase
Antiviral Agents
Child
Child, Preschool
Creatinine
Female
Humans
Infant
Male
Retrospective Studies
Risk Factors
Transaminases
