Safety and effectiveness of remdesivir in COVID-19 patients with liver dysfunction: a retrospective cohort study.

IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes and Metabolic Disorders Pub Date : 2025-10-23 eCollection Date: 2025-12-01 DOI:10.1007/s40200-025-01758-7

Amirmohammad Sharafi, Fatemeh Alsadat Mirzadeh, Abolfazl Zendehdel, Shnoo Bayazidi

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引用次数: 0

Abstract

Objective: This study aimed to assess the safety and effectiveness of remdesivir in hospitalized COVID-19 patients with liver dysfunction.

Methods: A retrospective cohort study analyzed medical records of 268 patients hospitalized between 2019 and 2022 with COVID-19 and elevated liver enzymes (AST and ALT). Patients were divided into remdesivir (N = 134) and non-remdesivir (N = 134) groups. Outcomes assessed included in-hospital mortality, 30-day mortality, adverse events, time to clinical improvement, and time to discharge. Statistical analyses included logistic regression with significance at p < 0.05.

Results: A total of 268 patients (134 receiving remdesivir and 134 controls) were included. The remdesivir group was older, had lower oxygen saturation, and presented with more severe disease at baseline. Despite these differences, remdesivir use was associated with a significantly faster clinical recovery (adjusted β = - 2.18 days; 95% CI: - 4.206 to - 0.154; p = 0.035). In-hospital mortality was higher in the remdesivir group (10.45% vs. 7.46%), but this difference was not statistically significant after adjustment (OR 0.12; 95% CI: 0.001-8.390; p = 0.109). Remdesivir nearly doubled the risk of serious adverse events (OR 1.90; 95% CI: 0.988-3.656), although this did not reach statistical significance (p = 0.054). Independent predictors of death or major adverse events included ICU admission, elevated ALP, and concomitant use of certain medications.

Conclusion: Remdesivir appears safe in COVID-19 patients with liver dysfunction and significantly shortens time to clinical improvement without increasing mortality or serious adverse events.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01758-7.

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瑞德西韦治疗COVID-19肝功能障碍患者的安全性和有效性：一项回顾性队列研究

目的：评价瑞德西韦治疗新冠肺炎住院肝功能障碍患者的安全性和有效性。方法：回顾性队列研究分析了2019 - 2022年住院的268例COVID-19肝酶（AST和ALT）升高患者的病历。将患者分为瑞德西韦组（N = 134）和非瑞德西韦组（N = 134）。评估的结局包括住院死亡率、30天死亡率、不良事件、临床改善时间和出院时间。结果：共纳入268例患者（接受瑞德西韦治疗的134例，对照组134例）。瑞德西韦组年龄较大，血氧饱和度较低，在基线时表现出更严重的疾病。尽管存在这些差异，瑞德西韦的使用与临床恢复明显更快相关（调整后的β = - 2.18天；95% CI: - 4.206至- 0.154;p = 0.035）。瑞德西韦组的住院死亡率更高（10.45%比7.46%），但调整后差异无统计学意义（OR 0.12; 95% CI: 0.001-8.390; p = 0.109）。Remdesivir使严重不良事件的风险几乎增加了一倍（OR 1.90; 95% CI: 0.988-3.656），尽管这没有达到统计学意义（p = 0.054）。死亡或主要不良事件的独立预测因子包括ICU入院、ALP升高和同时使用某些药物。结论：瑞德西韦对COVID-19肝功能障碍患者是安全的，可显著缩短临床改善时间，未增加死亡率或严重不良事件。补充资料：在线版本提供补充资料，网址为10.1007/s40200-025-01758-7。

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来源期刊

Journal of Diabetes and Metabolic Disorders Medicine-Internal Medicine

CiteScore

4.80

自引率

3.60%

发文量

210

期刊介绍： Journal of Diabetes & Metabolic Disorders is a peer reviewed journal which publishes original clinical and translational articles and reviews in the field of endocrinology and provides a forum of debate of the highest quality on these issues. Topics of interest include, but are not limited to, diabetes, lipid disorders, metabolic disorders, osteoporosis, interdisciplinary practices in endocrinology, cardiovascular and metabolic risk, aging research, obesity, traditional medicine, pychosomatic research, behavioral medicine, ethics and evidence-based practices.As of Jan 2018 the journal is published by Springer as a hybrid journal with no article processing charges. All articles published before 2018 are available free of charge on springerlink.Unofficial 2017 2-year Impact Factor: 1.816.