Evidence map›Paper›PMID 40457282›Full record

SynthesisBMC infectious diseases2025

Safety evaluation of remdesivir administration in patients with severe renal impairment and coronavirus disease: a systematic review and meta-analysis.

Takumi Umemura, Hideo Kato, Yoshikazu Mutoh, Mao Hagihara, Yoshiaki Ikeda, Hiroshige Mikamo

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Takumi UmemuraDepartment of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan.
Hideo KatoDepartment of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan.
Yoshikazu MutohDepartment of Clinical Infectious Diseases, Tosei General Hospital, Seto, Aichi, Japan.
Mao HagiharaDepartment of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan.
Yoshiaki IkedaCollege of Pharmacy, Kinjo Gakuin University, Nagoya, Aichi, Japan.
Hiroshige MikamoDepartment of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan. mikamo@aichi-med-u.ac.jp.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe conducted a comprehensive systematic review and meta-analysis to evaluate whether remdesivir (RDV) is safe for patients with severe renal impairment (SRI) and COVID-19, compared to non-SRI patients or those not receiving RDV.

methodsThis study was conducted according to the PRISMA guidelines for reporting systematic reviews and meta-analyses. We searched PubMed, Cohcrane, CINAHL, and Ichushi databases up to October 11, 2024. The outcomes assessed kidney injury, hepatic disorder and mortality. Randomized controlled trials and retrospective and cohort studies reporting kidney injury, hepatotoxicity, and mortality in (i) SRI patients treated with RDV versus without RDV or (ii) SRI patients versus non-SRI patients treated with RDV were included. Targeted patients were defined as adults with COVID-19 based on a positive reverse transcription polymerase chain reaction or rapid antigen test for SARS-CoV-2 from nasopharyngeal or salivary swabs regardless of symptoms.

resultsOne randomized controlled trial and 14 cohort studies met the inclusion criteria and were included in the final meta-analysis. Among SRI patients, RDV significantly reduced the incidence of kidney injury (risk ratio [RR] = 0.51, 95% confidence interval [CI] = 0.27-0.97) but had no significant difference in the development of hepatic disorder (RR = 0.88, 95% CI = 0.39-1.98) and mortality (RR = 0.79, 95% CI = 0.55-1.15). In the comparison between SRI and non-SRI patients treated with RDV, SRI patients demonstrated a significantly higher incidence of kidney injury (odds ratio [OR] = 2.51, 95% CI = 1.49-4.23), with no significant difference in the development of hepatic disorder (OR = 1.04, 95% CI = 0.43-2.53). Meanwhile, SRI patients treated with RDV exhibited significantly higher mortality than non-SRI patients treated with RDV (OR = 2.20, 95% CI = 1.51-3.22).

conclusionOur meta-analysis demonstrated that RDV administration in SRI patients with COVID-19 was safe compared to non-SRI or SRI patient treated without RDV. We suggest that the use of RDV should be actively considered for SRI patients.

Indexed as

Adenosine MonophosphateAlanineAntiviral AgentsCOVID-19 Drug TreatmentRenal InsufficiencyCOVID-19HumansRandomized Controlled Trials as TopicSARS-CoV-2Adenosine MonophosphateAlanineAntiviral AgentsremdesivirRemdesivirRenal impairmentSARS-CoV-2

Identifiers

PMID40457282
PMCPMC12128546

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.