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Remdesivir-induced Bradycardia is not Associated with Worse Outcome in Patients with COVID-19: A Retrospective Analysis

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 increas...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9402406/
https://www.ncbi.nlm.nih.gov/pubmed/36002783
http://dx.doi.org/10.1007/s40256-022-00547-4
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author 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
author_facet 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
author_sort Pantazopoulos, Ioannis
collection PubMed
description 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.
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spelling pubmed-94024062022-08-25 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 Am J Cardiovasc Drugs Original Research Article 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. Springer International Publishing 2022-08-25 2022 /pmc/articles/PMC9402406/ /pubmed/36002783 http://dx.doi.org/10.1007/s40256-022-00547-4 Text en © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Research Article
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
Remdesivir-induced Bradycardia is not Associated with Worse Outcome in Patients with COVID-19: A Retrospective Analysis
title Remdesivir-induced Bradycardia is not Associated with Worse Outcome in Patients with COVID-19: A Retrospective Analysis
title_full Remdesivir-induced Bradycardia is not Associated with Worse Outcome in Patients with COVID-19: A Retrospective Analysis
title_fullStr Remdesivir-induced Bradycardia is not Associated with Worse Outcome in Patients with COVID-19: A Retrospective Analysis
title_full_unstemmed Remdesivir-induced Bradycardia is not Associated with Worse Outcome in Patients with COVID-19: A Retrospective Analysis
title_short Remdesivir-induced Bradycardia is not Associated with Worse Outcome in Patients with COVID-19: A Retrospective Analysis
title_sort remdesivir-induced bradycardia is not associated with worse outcome in patients with covid-19: a retrospective analysis
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9402406/
https://www.ncbi.nlm.nih.gov/pubmed/36002783
http://dx.doi.org/10.1007/s40256-022-00547-4
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