safety of Remdesivir use in patients with acute or chronic kidney disease and covid 19 infection

COVID-19,caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), hasled to more than 50 million of infections and over 1 million deaths worldwide.Given the current, ongoing pandemic of COVID-19, there is a need to identifysafe and effective treatment options among so many available   drugs. Remdesivir (GS-5734), a prodrug ofadenosine analogues, has been shown to have antiviral activity against severalRNA viruses, including MERS-CoV ,Ebola virus and SARS-CoV-2..On May1, 2020, after review of unpublished data from available clinical trials, theUS Food and Drug Administration (US FDA) issued an emergency use authorization (EUA)to permit the use of remdesivir, a nucleotide analogue that inhibits viralRNA-dependent RNA polymerase (RDRP), for treatment of  severe coronavirus disease 2019 (COVID-19). Lateron October 22, 2020, FDA approved its use in adults andpediatric patients (12 years of age and older and weighing at least 40 kg) forthe treatment of COVID-19 requiring hospitalization.1Notably, patients with severe AKI and ESKD were excluded from this and allother remdesivir trials on the basis of eGFR cut-offs (either 50 or 30 ml/minper 1.73m2).  Hence   it isnot recommended in the group of patients where it required most just because oflack of data. But preliminary report suggests its use in these group ofpatients without its adverse effect on renal function.3. Based onthese data it has been used in these group of patients in our hospital as wellas all tertiary covid designated facilities after taking informed writtenconsent from patients’ relative as there is no other suitable alternativeexist. We want to analyse retrospectively its safety  in these patients.