Remdesivir, Sinus Bradycardia and Therapeutic Drug Monitoring in Children With Severe COVID-19

Rau, Cornelius; Apostolidou, Sofia; Singer, Dominique; Avataneo, Valeria; Kobbe, Robin

doi:10.1097/inf.0000000000003309

Cited by 6 publications

(5 citation statements)

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“…Сообщается о ряде случаев развития брадикардии во время приёма ремдесивира. Причём развитие брадикардии при использовании ремдесивира не имело связи с параллельным приёмом катехоламинов [29]. Также есть данные о развитии бессимптомной синусовой брадикардии с ЧСС до 50 ударов в минуту у трёх из 4 наблюдаемых детей с COVID-19 на фоне приёма ремдесивира, но, к счастью, ЧСС нормализовалась после отмены данных препаратов [30].…”

Section: Discussionunclassified

Cardiotoxic Drugs Used in the Treatment of COVID-19

Zmitrukevich,

Mamedova

2024

A&Ch

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Background. The COVID-19 pandemic is caused by the SARS-CoV-2 virus. Insufficient attention is paid to the cardiotoxic potential of the drugs used in the treatment of COVID-19.Aim. A brief report on the effect of the drugs commonly used in the treatment of COVID-19 on the cardiovascular system.Discussion. Various medications have been used to treat COVID-19. Some of the most common drugs include hydroxychloroquine, remdesvir, favipiravir, fluoroquinolones, interferon-α2b, glucocorticoids, molnupiravir, and ritonavir/nirmatrelvir. Most medications can cause changes in the cardiovascular system, especially in the QT interval.Conclusions. Physicians should take into account the cardiotoxic potential of all medications used in the treatment of COVID-19. Therapists and general practitioners should be aware of cardiovascular risks in the management of patients with COVID-19, as well as the prophylactic medical examinations of the population.

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Section: Discussionunclassified

Cardiotoxic Drugs Used in the Treatment of COVID-19

Zmitrukevich,

Mamedova

2024

A&Ch

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“…There have also been anecdotal reports of remdesivir-induced bradycardia in children. Some investigators, based on their experience, suggest the need for cardiovascular monitoring during remdesivir therapy as significant bradycardia may occur in treated patients [ 17 , 18 ]. At present, the mechanism by which remdesivir causes bradycardia is not fully understood.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the safety profile and therapeutic efficacy of remdesivir in children with SARS-CoV-2 infection – a single-center, retrospective, cohort study

Kautsch,

Wiśniowska,

Friedman-Gruszczyńska

et al. 2023

Eur J Pediatr

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Despite 3.5 years of the SARS-CoV-2 pandemic, we still lack effective drugs against COVID-19. The first and most widely used drug, remdesivir, has not yet been shown to be effective in adults. Even less is known about its effectiveness in children. Therefore, the aim of this retrospective study was to evaluate the safety and efficacy of remdesivir in pediatric patients with COVID-19 hospitalized in one medical center. The medical records of 328 children with COVID-19 were analyzed. Analysis was performed on the subgroups of children treated and not treated with remdesivir. Clinical data on general health, course of COVID-19 and treatment received were analyzed. Remdesivir was administered to 64 children, 16 to treat severe or critical illness and 48 because of the presence of risk factors to prevent progression to severe COVID-19. In children with severe COVID-19, remdesivir did not reduce the mortality rate. However, in patients with milder disease and risk factors, the drug significantly reduced the risk of progression to severe disease. Among adverse events, only mild aminotransferase elevations were observed in 4 patients, but none of these required discontinuation of treatment.Conclusions: Remdesivir is a safe treatment option for children with COVID-19. However, the efficacy of this therapy is still uncertain. It appears that in children with asymptomatic to moderate COVID-19 and risk factors for severe disease, remdesivir could be an effective method of prophylaxis. However, its efficacy in controlling severe disease is questionable and requires further study. What is Known:• There are still no effective drugs to combat COVID-19, and the efficacy of the widely used remdesivir in adults is controversial.• All recommendations and guidelines on the use of remdesivir in the pediatric population are based mainly on clinical trials in adults. What is New:• Remdesivir is a safe treatment for COVID-19 in the pediatric population.• In children with asymptomatic to moderate COVID-19 and risk factors for severe disease, remdesivir could be an effective drug to prevent disease progression. However, its efficacy in treating severe disease in children needs further exploration.

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“…Isolated reports regarding remdesivir-induced bradycardia in children have also been published in the literature. Some researchers, based on their experience, draw attention to the need for monitoring the cardiovascular system during remdesivir therapy, as signi cant bradycardia may occur in treated patients [17,18]. Currently, the mechanism by which remdesivir causes bradycardia is not fully understood.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the safety profile and therapeutic efficacy of remdesivir in children with SARS- CoV-2 infection – a single-centre, retrospective, cohort study

Kautsch,

Wiśniowska,

Friedman-Gruszczyńska

et al. 2023

Preprint

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Purpose Despite 3.5 years of the SARS-CoV-2 pandemic we still lack effective drugs against COVID-19. The first and most used one, remdesivir, still has not been clearly proven to be effective in the treatment of adults. Its effectiveness in children is even less known. Therefore, this retrospective study aimed to evaluate the safety and efficacy of remdesivir in paediatric patients with COVID-19 hospitalized in one medical centre. Methods Medical records of 328 children with COVID-19 were analyzed. The analysis was performed on the subgroups of children treated and not treated with remdesivir. Clinical data regarding general health condition, the course of COVID-19 and the administered treatment were analyzed. Results Remdesivir was administered to 64 children, 16 to treat severe or critical illness, and 48 due to the presence of risk factors to prevent progression to severe COVID-19. Among children with severe COVID-19 remdesivir did not reduce the death rate. However, in patients with milder courses and risk factors, the drug significantly reduced the risk of progression to severe disease. Among the adverse events, only mild elevations of aminotransferases were observed in 4 patients, but none of them required treatment discontinuation. Conclusions Remdesivir is a safe form of treatment in children with COVID-19. However, the effectiveness of such therapy is still uncertain. It seems that in children with asymptomatic to moderate COVID-19 and risk factors for severe disease, remdesivir could be an effective method of prophylaxis. However, its effectiveness in combating severe disease is questionable and requires further studies.

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Remdesivir, Sinus Bradycardia and Therapeutic Drug Monitoring in Children With Severe COVID-19

Cited by 6 publications

References 5 publications

Cardiotoxic Drugs Used in the Treatment of COVID-19

Cardiotoxic Drugs Used in the Treatment of COVID-19

Evaluation of the safety profile and therapeutic efficacy of remdesivir in children with SARS-CoV-2 infection – a single-center, retrospective, cohort study

Evaluation of the safety profile and therapeutic efficacy of remdesivir in children with SARS- CoV-2 infection – a single-centre, retrospective, cohort study

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