Remdesivir-induced Bradycardia is not Associated with Worse Outcome in Patients with COVID-19: A Retrospective Analysis.
Journal
American journal of cardiovascular drugs : drugs, devices, and other interventions
ISSN: 1179-187X
Titre abrégé: Am J Cardiovasc Drugs
Pays: New Zealand
ID NLM: 100967755
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
accepted:
02
08
2022
pubmed:
25
8
2022
medline:
2
11
2022
entrez:
24
8
2022
Statut:
ppublish
Résumé
COVID-19, is primarily a respiratory illness but is known to cause extrapulmonary manifestations, especially on the cardiovascular system. Bradycardia is commonly reported in COVID-19 patients despite no prior history of occurrence, and many studies have shown an association with increased mortality. Multiple case reports have been published showcasing remdesivir potentially causing bradycardia. Our aim was to investigate the incidence of bradycardia in patients receiving remdesivir and examine the association with disease severity and survival outcomes. A retrospective study was performed including 160 COVID-19 patients receiving remdesivir for 5 days. Patients' demographics, comorbidities, medication, vital signs, laboratory tests and outcome were recorded. Bradycardia was defined as a heart rate < 60 beats/min and severe bradycardia < 50 beats/min. One hundred eighteen (73.8%) patients experienced at least one episode of bradycardia during hospitalisation. Bradycardia was present in 12 (7.5%) patients before treatment with remdesivir. The rate of bradycardia increased up to the 6th day of hospitalisation (40.6%) and subsequently diminished and normalised within 5 days after the last remdesivir dose (5% at Day 10). Severe bradycardia was observed in 13 (7.5%) patients. No difference was observed in ICU admission between groups (bradycardia vs no bradycardia). When we stratified patients according to the outcome of hospitalisation, no significant difference was observed in the occurrence of bradycardia between groups (alive vs dead) [p = 0.853]. Treatment with remdesivir may be associated with new-onset bradycardia in hospitalised patients with COVID-19. However, bradycardia is transient and is not associated with ICU admission and mortality.
Sections du résumé
BACKGROUND
BACKGROUND
COVID-19, is primarily a respiratory illness but is known to cause extrapulmonary manifestations, especially on the cardiovascular system. Bradycardia is commonly reported in COVID-19 patients despite no prior history of occurrence, and many studies have shown an association with increased mortality. Multiple case reports have been published showcasing remdesivir potentially causing bradycardia. Our aim was to investigate the incidence of bradycardia in patients receiving remdesivir and examine the association with disease severity and survival outcomes.
METHODS
METHODS
A retrospective study was performed including 160 COVID-19 patients receiving remdesivir for 5 days. Patients' demographics, comorbidities, medication, vital signs, laboratory tests and outcome were recorded. Bradycardia was defined as a heart rate < 60 beats/min and severe bradycardia < 50 beats/min.
RESULTS
RESULTS
One hundred eighteen (73.8%) patients experienced at least one episode of bradycardia during hospitalisation. Bradycardia was present in 12 (7.5%) patients before treatment with remdesivir. The rate of bradycardia increased up to the 6th day of hospitalisation (40.6%) and subsequently diminished and normalised within 5 days after the last remdesivir dose (5% at Day 10). Severe bradycardia was observed in 13 (7.5%) patients. No difference was observed in ICU admission between groups (bradycardia vs no bradycardia). When we stratified patients according to the outcome of hospitalisation, no significant difference was observed in the occurrence of bradycardia between groups (alive vs dead) [p = 0.853].
CONCLUSIONS
CONCLUSIONS
Treatment with remdesivir may be associated with new-onset bradycardia in hospitalised patients with COVID-19. However, bradycardia is transient and is not associated with ICU admission and mortality.
Identifiants
pubmed: 36002783
doi: 10.1007/s40256-022-00547-4
pii: 10.1007/s40256-022-00547-4
pmc: PMC9402406
doi:
Substances chimiques
remdesivir
3QKI37EEHE
Adenosine Monophosphate
415SHH325A
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
705-710Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
Rev Cardiovasc Med. 2021 Jun 30;22(2):343-351
pubmed: 34258902
J Phys Chem B. 2020 Aug 13;124(32):6955-6962
pubmed: 32521159
J Pers Med. 2021 Sep 27;11(10):
pubmed: 34683102
Clin Ther. 2021 Mar;43(3):e57-e70
pubmed: 33549310
Clin Transl Sci. 2022 Feb;15(2):501-513
pubmed: 34719115
Clin Cardiol. 2021 Jun;44(6):857-862
pubmed: 33964035
J Med Virol. 2021 May;93(5):2631-2634
pubmed: 33620107
BMJ Case Rep. 2021 Sep 3;14(9):
pubmed: 34479903
Int J Environ Res Public Health. 2020 Oct 17;17(20):
pubmed: 33080869
JAMA. 2021 Mar 23;325(12):1164-1172
pubmed: 33755076
JACC Case Rep. 2020 Nov 18;2(14):2260-2264
pubmed: 33163977
J Infect. 2021 Aug;83(2):237-279
pubmed: 34052239
Int J Infect Dis. 2021 Oct;111:1-4
pubmed: 34333120
Am J Emerg Med. 2022 Sep;59:182-183
pubmed: 35577624
Circ Arrhythm Electrophysiol. 2021 Jul;14(7):e009811
pubmed: 34182791
Methodist Debakey Cardiovasc J. 2021 Dec 15;17(5):73-82
pubmed: 34992725
Postgrad Med J. 2022 Jul;98(1161):501-502
pubmed: 34876485
Radiology. 2020 Jun;295(3):715-721
pubmed: 32053470
Toxicol Rep. 2021;8:1394-1398
pubmed: 34258235