Remdesivir-associated bradycardia in COVID-19: a rapid review protocol

Abstract

IntroductionRemdesivir is an antiviral medication that is used in the treatment of severe COVID-19. Research has highlighted the potential cardiac side effects of remdesivir, including the occurrence of remdesivir-associated bradycardia (RAB), but these findings have not been consistent. In addition, very little is known about the clinical implications and outcomes of RAB. The aim of this rapid systematic review is to determine the event rate of developing bradycardia while receiving remdesivir treatment compared with not receiving remdesivir in patients diagnosed with COVID-19.Methods and analysisThis study follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol guidelines and will include original papers related to COVID-19, remdesivir and bradycardia. Only English language papers published from 1 December 2019 to 31 December 2022 will be included. The following databases will be searched using keywords and controlled vocabulary: Ovid MEDLINE, Ovid EMBASE, Scopus, Cochrane, PubMed and Web of Science. Two reviewers will independently perform screening and data abstraction. Data will be synthesised qualitatively as well as quantitatively. A random-effects model will be used to calculate the pooled estimates.Ethics and disseminationThis review will systematically analyse the clinical studies available to help better characterise RAB. The results will support a retrospective study investigating RAB that is currently being conducted at the University Medical Center of Southern Nevada in Las Vegas, Nevada.PROSPERO registration numberThis protocol has been submitted to and approved by PROSPERO (Protocol ID: CRD42022331614).

Dual inhibition of coronavirus Mproand PLproenzymes by phenothiazines and their antiviral activity

“…Furthermore, both Paxlovid™ and remdesivir have been shown to cause severe adverse effects in some patients [Hammond et al, 2022;Reis et al, 2022;Tian et al, 2023], particularly in patients with medicated comorbidities who are at higher risk for COVID-19 complications [Cao et al, 2023;Prikis and Cameron, 2022].…”

“…As this drug is rapidly metabolized by cytochrome P450, it is co-formulated with ritonavir, a cytochrome P450 3A4 (CYP3A4) inhibitor, to make the drug cocktail, Paxlovid™, which is currently the front-line antiviral treatment for SARS-CoV-2 infection [Hammond et al, 2022; Food and Drug Administration, 2022; Owen et al, 2021]. Furthermore, both Paxlovid™ and remdesivir have been shown to cause severe adverse effects in some patients [Hammond et al, 2022; Reis et al, 2022; Tian et al, 2023], particularly in patients with medicated comorbidities who are at higher risk for COVID-19 complications [Cao et al, 2023; Prikis and Cameron, 2022].…”