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Efficacy of remdesivir for hospitalized COVID-19 patients with end stage renal disease

World Journal of Critical Care Medicine 2022年第1期11卷 48-57页

作者： Vijairam Selvaraj amos lal Arkadiy Finn Joshua Ray Tanzer Muhammad Baig Atin Jindal Kwame Dapaah-Afriyie George Bayliss Department of Medicine Miriam HospitalWarren Alpert Medical School of Brown UniversityProvidenceRI 02906United States Department of Medicine Division of Pulmonary and Critical CareMayo ClinicRochesterMN 55905United States Department of Biostatistics Core Lifespan GroupProvidenceRI 02906United States Department of Medicine Rhode Island Hospital and Alpert Medical SchoolBaylissDivision of Kidney and HypertensionBrown UniversityProvidenceRI 02906United States

BACKGROUND Since the beginning of corona virus disease 2019(COVID-19)pandemic,there has been a widespread use of remdesivir in adults and *** is little known information about its outcomes in patients with end stage renal disease who are on *** To assess the clinical outcomes with use of remdesivir in adult patients with end stage kidney failure on *** A retrospective,multicenter study was conducted on patients with end stage renal disease on hemodialysis that were discharged after treatment for COVID-19 between April 1,2020 and December 31,*** endpoints were oxygen requirements,time to mortality and escalation of care needing mechanical *** A total of 45 patients were included in the *** patients received remdesivir,and 25 patients did not receive *** patients were caucasian,females with diabetes mellitus and hypertension being the commonest *** was a trend towards reduced oxygen requirement(beta=-25.93,X^(2)(1)=6.65,P=0.0099,probability of requiring mechanical ventilation(beta=-28.52,X^(2)(1)=22.98,P<0.0001)and mortality(beta=-5.03,X^(2)(1)=7.41,P=0.0065)in patients that received remdesivir compared to the control *** Larger studies are justified to study the effects of remdesivir in this high-risk population with end stage kidney disease on dialysis.

关键词： COVID-19 Remdesivir End stage renal disease Dialysis Hemodialysis Kidney disease

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Anticoagulant use before COVID-19 diagnosis prevent COVID-19 associated acute venous thromboembolism or not:A systematic review and meta-analysis

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World Journal of Methodology 2024年第3期14卷 141-162页

作者： Kinza Iqbal Akshat Banga Taha Bin Arif Sawai Singh Rathore Abhishek Bhurwal Syeda Kisa Batool Naqvi Muhammad Mehdi Pankaj Kumar Mitali Madhu Salklan Ayman Iqbal Jawad Ahmed Nikhil Sharma amos lal Rahul Kashyap Vikas Bansal Juan Pablo Domecq Department of Internal Medicine Dow Medical CollegeKarachi 74200Pakistan Department of Internal Medicine Sawai Man Singh Medical CollegeJaipur 302004India Department of Internal Medicine Dr.Sampurnanand Medical CollegeJodhpur 342003RajasthanIndia Department of Gastroenterology and Hepatology Rutgers Robert Wood Johnson School of MedicineNew BrunswickNJ 08901United States Department of Internal Medicine Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical SciencesRohtak 124001HaryanaIndia Department of Nephrology and Hypertension Mayo ClinicRochesterMN 55905United States Department of Medicine Division of Pulmonary and Critical Care MedicineMayo ClinicRochesterMN 55905United States Department of Research Wellspan HealthYorkPA 17403United States

BACKGROUND Coagulopathy and thromboembolic events are associated with poor outcomes in coronavirus disease 2019(COVID-19)*** is conflicting evidence on the effects of chronic anticoagulation on mortality and severity of COVID-19 *** To summarize the body of evidence on the effects of pre-hospital anticoagulation on outcomes in COVID-19 *** A Literature search was performed on LitCovid PubMed,WHO,and Scopus databases from inception(December 2019)till June 2023 for original studies reporting an association between prior use of anticoagulants and patient outcomes in adults with *** primary outcome was the risk of thromboembolic events in COVID-19 patients taking *** outcomes included COVID-19 disease severity,in terms of intensive care unit admission or invasive mechanical ventilation/intubation requirement in patients hospitalized with COVID-19 infection,and *** random effects models were used to calculate crude and adjusted odds ratios(aORs)with 95%confidence intervals(95%CIs).RESULTS Forty-six observational studies met our inclusion *** unadjusted analysis found no association between prior anticoagulation and thromboembolic event risk[n=43851,9 studies,odds ratio(OR)=0.67(0.22,2.07);P=0.49;I2=95%].The association between prior anticoagulation and disease severity was non-significant[n=186782;22 studies,OR=1.08(0.78,1.49);P=0.64;I2=89%].However,pre-hospital anticoagulation significantly increased all-cause mortality risk[n=207292;35 studies,OR=1.72(1.37,2.17);P<0.00001;I2=93%].Pooling adjusted estimates revealed a statistically non-significant association between pre-hospital anticoagulation and thromboembolic event risk[aOR=0.87(0.42,1.80);P=0.71],mortality[aOR=0.94(0.84,1.05);P=0.31],and disease severity[aOR=0.96(0.72,1.26);P=0.76].CONCLUSION Prehospital anticoagulation was not significantly associated with reduced risk of thromboembolic events,improved survival,and lower disease seve

关键词： Prior anticoagulation COVID-19 Prehospital anticoagulation Chronic anticoagulation Mortality Severity Thromboembolic events

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