Early Remdesivir May Protect Kidney Transplants After COVID-19: Nitipong Permpalung, MD, MPH

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Among patients who underwent kidney transplants and were treated for COVID-19, those who received at least 3 consecutive days of remdesivir (Veklury; Gilead Sciences) were less likely to experience all-cause graft loss (ACGL) and cardiovascular events.¹

The study, newly published in JAMA Network Open, evaluated the risk of severe COVID infection in kidney transplant patients—an often-underrepresented population in COVID antiviral studies, Nitipong Permpalung, MD, MPH, corresponding author and associate director of the Johns Hopkins Transplant Research Center, said in an interview with The American Journal of Managed Care^®.

“I do think that the findings suggest the potential benefits of treating COVID-19 early may extend beyond the short-term benefits that the early clinical trials have shown,” he said. “The early treatment may also help reduce some of the long-term complications that are important in our transplant recipients.”

However, the findings should be confirmed in a larger, more diverse patient population, as the current study only consisted of 432 adults who were kidney transplant recipients with symptomatic COVID-19. ACGL occurred in 48 patients (11.1%) in the follow-up: 26 of 177 in the early remdesivir group and 22 of 225 in the no-remdesivir group.¹

“I do think that we need to understand better why early treatment may reduce the graft loss and cardiovascular events,” Permpalung said. “I think we also need to understand whether the findings can apply to other solid organ transplant populations, if it can protect lung allografts, heart allografts, or liver allografts.”

There are also numerous other measures to test across different organ transplant recipients, the best treatment duration, antivirals vs no antivirals, and patient outcomes or long-term complications, he noted.

“I think the future research should focus on the treatment system and how to provide 3-day intravenous treatment quickly and equitably without unnecessary hospitalization just to get the IV infusion alone,” Permpalung said.

Reference

1. Srisurapanont K, Manothummetha K, Sirivakorn N, et al. Remdesivir and all-cause graft loss among kidney transplant recipients with symptomatic COVID-19. JAMA Netw Open. 2026;9;(7):e2625591. doi:10.1001/jamanetworkopen.2026.25591