Author(s): Dwita Riadini, Puspa Wardhani, Yessy Puspitasari, M. Robiul Fuadi

Email(s): puspa-w-2@fk.unair.ac.id

DOI: 10.52711/0974-360X.2024.00244   

Address: Dwita Riadini1, Puspa Wardhani1,2,3*, Yessy Puspitasari1,2, M. Robiul Fuadi1,2, Yulia Nadar Indrasari1,2, Kustiah1, Bambang Pujo Semedi4 1Clinical Pathology Specialist Study Programme, Department of Clinical Pathology, Faculty of Medicine Airlangga University/Dr. Soetomo General Academic Teaching Hospital, Surabaya, East Java, Indonesia. 2Department of Clinical Pathology, Faculty of Medicine Airlangga University/ Dr. Soetomo General Academic Teaching Hospital, Surabaya, East Java, Indonesia. 3Postgraduate School of Universitas Airlangga. 4Department of Anaestesiology and Reanimation, Faculty of Medicine Airlangga University/ Dr. Soetomo General Academic Teaching Hospital, Surabaya, East Java, Indonesia. *Corresponding Author

Published In:   Volume - 17,      Issue - 4,     Year - 2024


ABSTRACT:
Background: Remdesivir (RDV) is a broad-spectrum antiviral approved by the Food and Drug Administration (FDA) for the treatment of Covid-19 patients, known to have the potential to cause toxic effects on the liver. Routine monitoring of liver biochemical parameters such as AST, ALT, bilirubin, ALP and GGT, can help detect liver injury. Drug-induced liver injury, according to Hy's law, is characterized by an increase in ALT > 5x ULN, or ALP > 2x ULN, or an increase in ALT > 3x and total bilirubin > 2x ULN, simultaneously. Glutamate dehydrogenase (GLDH) is a sensitive and specific hepatic marker, which can detect liver injury and loss of mitochondrial integrity earlier than other liver biochemical parameters. This study aimed to analyze GLDH levels and liver biochemical parameters before and after RDV therapy in patients with Covid-19. We also analyze several factors that affect liver function and suggest renal function. Methods: This study used an observational analytical with a prospective cohort design, in a population of Covid-19 patients receiving RDV therapy at the infectious emergency department and isolation ward Dr. Soetomo Surabaya for September-November. Consecutive sampling was taken. The subject had drawn blood twice; once before therapy and 5 days after receiving intravenous RDV. GLDH examination is using sandwich ELISA method, while ALT, AST, ALP, GGT, direct and total bilirubin were determined spectrophotometrically. Mann-whitney, the Wilcoxon rank test and Spearman correlation test were used to analyze the data. Results: The number of samples was 34 participants with an average age of 52.47+15.21 years. Concomitant medications were dominated by n-acetylcysteine (94.1%), antioxidants (91.2%) and immunomodulators (82.4%). None of the subjects suffered liver injury induced by RDV according to Hy’s Law. Median GLDH serum levels before RDV treatment 1,14 U/L and after 5 days RDV administration 0,85 U/L (p=0,945), AST (36,4 U/L; 34, 00U/L; p=0,140), ALT (30,43 U/L; 30,20 U/L; p=0,301), DBI (0,15mg/dL; 0,24mg/dL; p=0,090), TBI (0,49mg/dL; 0,50mg/dL; p=0,567), ALP (85,0U/L; 87, 5 U/L; p=0,313) dan GGT (64,5U/L; 71,0U/L; p=0,871). The use of concomitant medication was thought to have protective properties against hepatocytes. Conclusion: After 5 days of RDV treatment, there is no evidence of liver injury. There are no significant differences in GLDH levels and other liver biomarker parameters compared to baseline. There is no difference in delta GLDH levels between groups with and without renal impairment.


Cite this article:
Dwita Riadini, Puspa Wardhani, Yessy Puspitasari, M. Robiul Fuadi. Differences in Glutamate Dehydrogenase (GLDH) and Other Liver Biochemistry Levels before and after Remdesivir Treatment in COVID-19. Research Journal of Pharmacy and Technology.2024; 17(4):1544-0. doi: 10.52711/0974-360X.2024.00244

Cite(Electronic):
Dwita Riadini, Puspa Wardhani, Yessy Puspitasari, M. Robiul Fuadi. Differences in Glutamate Dehydrogenase (GLDH) and Other Liver Biochemistry Levels before and after Remdesivir Treatment in COVID-19. Research Journal of Pharmacy and Technology.2024; 17(4):1544-0. doi: 10.52711/0974-360X.2024.00244   Available on: https://rjptonline.org/AbstractView.aspx?PID=2024-17-4-18


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