Extracorporeal membrane oxygenation may decrease the plasma concentration of remdesivir in a patient with severe coronavirus disease 2019. (2021)

• Record Type: Journal Article
• Authors: Ide, Satoshi; Saito, Sho; Akazawa, Tsubasa; Furuya, Takahito; Masuda, Junichi; Nagashima, Maki; Asai, Yusuke; Ogawa, Tatsunori; Yamamoto, Ryohei; Ishioka, Haruhiko; Kanda, Kohei; Okuhama, Ayako; Wakimoto, Yuji; Suzuki, Tetsuya; Akiyama, Yutaro; Miyazato, Yusuke; Nakamura, Keiji; Nakamoto, Takato; Nomoto, Hidetoshi; Moriyama, Yuki; Ota, Masayuki; Morioka, Shinichiro; Matsuda, Wataru; Uemura, Tatsuki; Kobayashi, Kentaro; Sasaki, Ryo; Katagiri, Daisuke; Kutsuna, Satoshi; Hayakawa, Kayoko; Ohmagari, Norio
• Is Part Of: IDCases. Volume 26(2021)
• Publication Date: 2021
• Subjects: Remdesivir -- Severe COVID-19 -- Extracorporeal membrane oxygenation -- Pharmacokinetics analysis; Communicable diseases -- Periodicals; Communicable Diseases -- Case Reports; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; 616.9
• DOI: 10.1016/j.idcr.2021.e01343
• Languages: English
• ISSNs: 2214-2509

Abstract

Abstract: Remdesivir is an antiviral drug that results in clinical improvement after five days of treatment and accelerates recovery by 31%. No studies have discussed the pharmacokinetic analysis of remdesivir in patients with severe COVID-19 requiring extracorporeal membrane oxygenation (ECMO). A 63-year-old American man who underwent mechanical ventilation and ECMO for severe COVID-19 was administered remdesivir for ten days. The loading dosage was 200 mg at 7 PM on day 12 and 100 mg daily at 0:00 PM from day 13–21, administered within 1 h. The pharmacokinetic analysis was performed. The serum creatinine concentration was within the normal range of 0.5–0.7 mg/dL during treatment. According to the pharmacokinetic analysis, the plasma concentrations of remdesivir and GS-441524 4 h after administration (C4 ) were 662 ng/mL and 58 ng/mL, respectively, and the concentrations 18 h after administration (C18 ) were 32 ng/mL and 44 ng/mL, respectively. Therefore, the half-life of remdesivir and GS-441524 was 3.2 and 35.1 h, respectively. Monitoring the plasma concentrations of remdesivir and GS-441524 in patients undergoing ECMO may be necessary. Highlights: A COVID-19 patient undergoing ECMO was administered remdesivir. The loading dosage was 200 mg at 7:00 PM on day 12. From days 13–21, it was 100 mg daily at 0:00 PM administered within 1 h. The half-lives of remdesivir and GS-441524 were 3.2 and 35.1 h, respectively. Plasma concentrations of remdesivir and GS-441524 must be monitored during ECMO.