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Remdesivir-induced Bradycardia is not Associated with Worse Outcome in Patients with COVID-19: A Retrospective Analysis.
Pantazopoulos, Ioannis; Mavrovounis, Georgios; Dimeas, Georgios; Zikos, Nikolaos; Pitsikou, Maria; Rousogianni, Eleni; Mermiri, Maria; Michou, Anastasia; Spanos, Michalis; Maniotis, Christos; Chalkias, Athanasios; Laou, Eleni; Zakynthinos, Georgios; Chatzis, Dimitrios; Gourgoulianis, Konstantinos.
  • Pantazopoulos I; Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece. pantazopoulosioannis@yahoo.com.
  • Mavrovounis G; Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
  • Dimeas G; Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
  • Zikos N; Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
  • Pitsikou M; Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
  • Rousogianni E; Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
  • Mermiri M; Department of Anaesthesiology, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
  • Michou A; Department of Anaesthesiology, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
  • Spanos M; Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
  • Maniotis C; Hygeia hospital, 151 23, Marousi, Athens, Greece.
  • Chalkias A; Department of Anaesthesiology, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
  • Laou E; Department of Anaesthesiology, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
  • Zakynthinos G; Third Department of Cardiology, Sotiria General Hospital, 11527, Athens, Greece.
  • Chatzis D; European University of Cyprus, Medical School, Nicosia, Cyprus.
  • Gourgoulianis K; Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
Am J Cardiovasc Drugs ; 22(6): 705-710, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2000144
ABSTRACT

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:

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:

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:

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.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Am J Cardiovasc Drugs Journal subject: Vascular Diseases / Cardiology / Drug Therapy Year: 2022 Document Type: Article Affiliation country: S40256-022-00547-4

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Am J Cardiovasc Drugs Journal subject: Vascular Diseases / Cardiology / Drug Therapy Year: 2022 Document Type: Article Affiliation country: S40256-022-00547-4