Early use of the intravenous antiviral drug remdesivir (RDV) may reduce the risk of death by 28 days in adults with kidney or liver disease hospitalized for COVID-19, scientists from the University of Illinois and drug maker Gilead Sciences report today in Clinical Infectious Diseases.

The researchers analyzed medical claims and hospital cost data for early RDV initiation among US adults diagnosed as having kidney or liver disease hospitalized for COVID-19 from 2021 to 2025. The patients, and controls who didn’t receive RDV, were stratified by supplemental oxygen use in the first two days after admission.

In total, 22,378 patients (11,189 each of RDV recipients and controls) had kidney disease, and 5,026 patients (2,513 per group) had liver disease.

The kidney cohort included patients with kidney disease who required renal replacement therapy in the year before RDV initiation. The liver cohort was made up of patients with conditions such as liver injury, cirrhosis, liver failure, and noninfectious hepatitis.

The risk of 28-day all-cause in-hospital death was lower among RDV recipients in both the kidney cohort (25% lower) and liver cohort (24% lower) than among controls. Nearly 70% of all patients in each cohort needed supplemental oxygen.

The current study provides additional evidence to support the use of RDV to treat COVID-19 in patients with both renal [kidney] comorbidities and hepatic comorbidities.

The risk of death was 25% and 26% lower with early RDV use among kidney and liver patients who received supplemental oxygen and 49% lower in liver patients who didn’t receive oxygen. The decrease in kidney patients who didn’t receive oxygen wasn’t statistically significant.

“Since RDV is metabolized primarily through the liver, hepatic [liver] laboratory testing is recommended before and during RDV treatment,” the researchers wrote. “Nevertheless, the current study provides additional evidence to support the use of RDV to treat COVID-19 in patients with both renal [kidney] comorbidities and hepatic comorbidities.”

A new study in The Lancet Child & Adolescent Health of children younger than 5 years old seeking care for acute gastroenteritis at hospitals or emergency departments in one of 22 countries from July 1, 2007, to Aug 24, 2023, shows the rotavirus vaccine offered strong protection against acute gastrointestinal illness and death.

Rotavirus accounts for an estimated 25% of diarrhea deaths in children under 5 globally. Yet despite a vaccine being widely available for 20 years, the International Vaccine Access Center estimates that 70 million infants remained unprotected in 2024.

The study used databases to include 27,252 children younger than 5 years enrolled from 22 countries. In total, 183 all-cause acute gastroenteritis deaths and 25 rotavirus-positive deaths were reported, the authors said. 

Among children aged at least 3 months who had received any routine vaccines, receiving at least one dose of a rotavirus vaccine had an adjusted vaccine effectiveness of 75.8% against rotavirus-positive acute gastroenteritis mortality, and 20.8% against all-cause acute gastroenteritis mortality.

“This study is the first to calculate rotavirus vaccine effectiveness against rotavirus-positive acute gastroenteritis mortality, which we did by combining acute gastroenteritis surveillance and rotavirus vaccine effectiveness and impact studies from 16 countries,” the authors wrote. 

In an accompanying commentary, Daniel Hungerford, PhD, and Latif Ndeketa, MD, PhD, both of the University of Liverpool, wrote, “These findings provide the strongest multicountry evidence to date that rotavirus vaccines substantially reduce rotavirus-associated diarrhoea mortality in high-burden settings.”