Safety outcomes of remdesivir for treatment of COVID-19 hospitalised patients in Indonesia

Background: Remdesivir has been granted emergency use authorisation for hospitalised COVID-19 patients. However, the available evidence in Indonesia is limited to related liver and kidney injuries. Objective: This study aims to assess the safety of remdesivir based on liver and kidney function and its association with comorbidity and disease severity. Method: This retrospective study evaluated remdesivir's efficacy in hospitalised COVID-19 patients of varying severity by collecting baseline and follow-up data on aspartate aminotransferase (AST), alanine aminotransferase (ALT), Glomerular filtration rate (GFR) and Blood urea nitrogen (BUN). Result: In this study, 189 patients with elevated transaminase enzyme levels were given hepatoprotection therapy. Patients who did not receive the treatment experienced a significant rise in ALT levels (p < 0.001), while BUN levels increased significantly (p = 0.001) but within the normal range. There was no worsening of GFR value (p < 0.001), and no significant association was found between AST and ALT levels with comorbidity and disease severity (p < 0.001; OR 50.202). Conclusion: Remdesivir demonstrated good tolerability despite increased ALT and BUN without correlating to comorbidity or disease severity in COVID-19.