Pharmacotherapy for COVID-19 treatment in patients with renal impairment: a updated review

Abstract

COVID-19 has been identified the cause of several cases of pneumonia in China. The etiologic agent of the disease (SARS-CoV-2 virus) has a binding structure to the angiotensin-converting enzyme 2 (ACE2) receptor, allowing entry into cells that express ACE2, such as pulmonary alveolar epithelial cells. However, studies also show the possibility of damage of renal cells since these cells express high levels of ACE2. Currently, there is no evidence to indicate a specific treatment for COVID-19. Several drugs have been used and some of them may altered the elimination process in patients with renal impairment. To date, there are no studies that assist health professionals in dosing adjustment of these drugs. Thus, this study aimed to review and discuss the issue, considering the factors related to kidney injury in COVID-19, as well as pharmacokinetic aspects and dose recommendations of majority of drugs used for COVID-19.