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

摘要

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.