Kidney transplant recipients face severe COVID-19 risks but often are excluded from key antiviral trials.In a target trial emulation, starting remdesivir (Veklury) soon after a COVID diagnosis was associated with a 47% lower risk of graft failure or death at 1 year.Early remdesivir also was associated with a 42% lower risk of cardiovascular events.
Kidney transplant recipients with COVID-19 who received remdesivir (Veklury) early had a lower risk of graft loss, a target trial emulation study found.
Compared with no remdesivir, initiation of the antiviral within 7 days of a COVID diagnosis was associated with a 47% lower risk of graft failure or death at 1 year in an analysis that employed clone-censor-weight adjustment (HR 0.53, 95% CI 0.31-0.92), reported Nitipong Permpalung, MD, MPH, of Johns Hopkins University School of Medicine in Baltimore, and colleagues.
This association was generally consistent across clinically relevant subgroups, according to the findings in JAMA Network Open, and early remdesivir was also associated with a 42% lower risk of cardiovascular events (HR 0.58, 95% CI 0.35-0.98).
"The main message for clinicians is to act early," Permpalung told MedPage Today. "When a kidney transplant recipient develops COVID-19 symptoms or tests positive, the patient should contact the transplant team promptly, and antiviral treatment should be considered before the illness becomes severe."
