Acute pancreatitis or severe increase in pancreatic enzyme levels following remdesivir administration in COVID-19 patients: an observational study

• Published in: Scientific reports Vol. 12; no. 1; pp. 5323 - 10
• Main Authors: Miyazaki, Kazuhito, Yoshimura, Yukihiro, Miyata, Nobuyuki, Sasaki, Hiroaki, Shiba, Aya, Aga, Masaharu, Hamakawa, Yusuke, Taniguchi, Yuri, Misumi, Yuki, Agemi, Yoko, Shimokawa, Tsuneo, Okamoto, Hiroaki, Tachikawa, Natsuo
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 29.03.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/699/1785; 692/699/255/2514; Acute Disease; Adenosine Monophosphate - analogs & derivatives; Alanine - analogs & derivatives; Antiviral drugs; Coronaviruses; COVID-19; COVID-19 Drug Treatment; Enzymes; Humanities and Social Sciences; Humans; multidisciplinary; Multivariate analysis; Observational studies; Pancreas; Pancreatitis; Pancreatitis - drug therapy; Patients; Retrospective Studies; Risk factors; Science; Science (multidisciplinary); Japan
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-09170-4

Remdesivir has been shown to reduce recovery time and mortality among patients with coronavirus disease 2019 (COVID-19). However, data regarding the efficacy and safety of remdesivir use are limited in Japan. We conducted a single-center retrospective cohort study at Yokohama Municipal Citizen’s Hospital, Kanagawa, Japan. Patients with COVID-19 pneumonia treated with remdesivir were included. The onset of acute pancreatitis and increased pancreatic enzyme levels and clinical, laboratory, treatment, and outcome data were collected and analyzed. A total of 201 patients were included. Among the 201 patients treated with remdesivir, 177 recovered from COVID-19. Increased pancreatic enzyme levels of grade 3 or higher or acute pancreatitis developed in 23 of the 201 patients. The potential etiopathogenetic effects of remdesivir on increased pancreatic enzyme levels of grade 3 or higher or acute pancreatitis were ascertained by reviewing the characteristics of patients hospitalized for COVID-19 who did not receive remdesivir treatment. Only 3 of 159 patients had increased pancreatic enzyme levels of grade 3 or higher during the treatment course. Multivariate analysis indicated remdesivir administration and severe COVID-19 infection by National Institute of Health standards as independent risk factors. Acute pancreatitis and severe increases in pancreatic enzyme levels were observed among patients with COVID-19 treated with remdesivir.