Remdesivir-Induced Bradycardia in COVID-19: A Single Center Prospective Study

Bradycardia during remdesivir treatment might be associated with improved survival in patients with COVID-19: a retrospective cohort study on 473 patients from a tertiary centre

“…Our results demonstrate that bradycardia occurring during remdesivir use might reflect more favourable disease course and has a substantial potential for improving prognostication of patients with COVID-19. Frequency of bradycardia in our cohort (16.8%) was lower than previously reported in smaller patient cohorts (19%-47%) [2][3][4] which could be attributed to differences in baseline age, sex and comorbidity profile of patients. Underlying mechanisms behind bradycardia temporally associated with the administration of remdesivir remain elusive at the moment.…”

“…Remdesivir is the only antiviral drug currently approved for the treatment of severe COVID-19. It was recently observed that use of remdesivir might be associated with higher frequency of transitory bradycardia, [1][2][3][4] a phenomenon that was reported in 19%-47% of remdesivir-treated patients without clear clinical significance. Since a number of other potentially detrimental cardiovascular adverse events were reported with remdesivir use, 5 understanding clinical consequences of these phenomena is of outmost importance in everyday clinical practice.…”

“…Median Charlson Comorbidity Index (CCI) was 3 IQR. [2][3][4] At the time of hospital admission, a total of 382 (80.8%) patients presented with severe and 83 (17.5%) with critical COVID-19 symptoms. Median C reactive protein and interleukin-6 levels on admission were 110.7 mg/L and 44.2 pg/mL, respectively.…”

Pulmonary Edema in COVID-19 Treated with Furosemide and Negative Fluid Balance (NEGBAL): A Different and Promising Approach

“…Fourth, we observed that heart rate showed a tendency to bradycardia. Sinus bradycardia is common and paradoxical in COVID-19 [ 38 , 39 , 40 ] and have been related to favipiravir [ 41 ], SIADH [ 42 ], hydroxychloroquine [ 43 ], remdesivir [ 44 , 45 ], lopinavir–ritonavir [ 46 ], among other multiple explanations. It is interpreted that it may be another indirect evidence of abnormal hypervolemia, which generates an increase in preload and, by Frank Starling’s law, increase in stroke volume, resulting in a cardiac adaptive response, with a decrease in heart rate.…”

Remdesivir-Associated Sinus Arrest in COVID-19: A Potential Indication for Close Cardiac Monitoring

“…The study found that remdesivir was associated with an increased odds ratio of bradycardic episodes [ 11 ]. A different analysis of patients on remdesivir determined that remdesivir was associated with higher rates of bradycardia than the control group [ 12 ]. The findings in this study are supported by our case, as our patient developed sinus bradycardia prior to developing sinus arrest while on remdesivir therapy.…”