Impact of remdesivir on liver function: A comparative study of diabetic and non-diabetic COVID-19 patients

Abstract

This study aimed to evaluate the effect of remdesivir on liver tests in diabetic and non-diabetic COVID-19 patients through a multicenter study conducted in Southeast Iran. Therefore, 200 participants, comprising 98 patients with diabetes and 102 non-diabetic subjects, were assessed based on the Declaration of Helsinki, with proper inclusion, and exclusion criteria. Demographic data were collected using a detailed questionnaire and a clinical checklist documenting underlying health conditions, particularly diabetes and hypertension. Liver function tests measured key enzymes and substances, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin, and data analysis was performed using SPSS (Confidence Interval = 0.95, p ≤ 0.05). Key findings indicate a significant correlation between increasing age and diabetes prevalence, with older age groups exhibiting higher rates of diabetes. Gender analysis revealed a slight predominance of females among diabetic patients, while educational attainment appeared lower in this group, suggesting a potential link between education and diabetes incidence. In patients with diabetes, AST levels rose from 19.2 ± 2.1 U/L before treatment to 25.3 ± 3.1 U/L after treatment, while ALT levels increased from 18.1 ± 1.4 U/L to 23.5 ± 2.2 U/L. Non-diabetic patients showed less pronounced increases in liver enzymes, with AST rising from 28.7 ± 3.1 U/L to 13.2 ± 2.1 U/L after treatment and ALT changing from 18.6 ± 3.2 U/L to 19.6 ± 3.1 U/L. Health-related factors, particularly the prevalence of hypertension and obesity, were notably higher among patients with diabetes. Lifestyle behaviors, including smoking and physical activity levels, further distinguished the two groups, with patients with diabetes showing a higher smoking prevalence and a lower engagement in regular exercise. The impact of remdesivir treatment on liver function revealed significant increases in liver enzyme levels among patients with diabetes post-treatment, contrasting with stable liver function in non-diabetic patients. The study underscores the intricate relationship between diabetes, liver health, and COVID-19, emphasizing the importance of considering comorbidities in treatment and management strategies for diabetic patients.