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Case Reports
. 2020 Nov 18;2(14):2260-2264.
doi: 10.1016/j.jaccas.2020.08.025. Epub 2020 Oct 28.

Marked Sinus Bradycardia Associated With Remdesivir in COVID-19: A Case and Literature Review

James C Gubitosa  1 , Parul Kakar  2 , Christine Gerula  2 , Hernando Nossa  3 , Diana Finkel  3 , Kristin Wong  4 , Megna Khatri  4 , Hasan Ali  1
Affiliations
Case Reports

Marked Sinus Bradycardia Associated With Remdesivir in COVID-19: A Case and Literature Review

James C Gubitosa et al. JACC Case Rep. .

Abstract

Remdesivir has seen extensive use during the coronavirus disease-2019 pandemic given its clinically proven efficacy against severe acute respiratory syndrome coronavirus type 2. There has been little cited regarding adverse effects. Here we present the case of a patient with marked sinus bradycardia that began acutely on initiation of remdesivir and resolved almost immediately on cessation of the drug. (Level of Difficulty: Beginner.).

Keywords: AV, atrioventricular; COVID-19, coronavirus disease-2019; ECG, electrocardiogram; LBBB, left bundle branch block; bradycardia; cancer; cardiovascular disease; chest pain; electrocardiogram; electrophysiology; h-mtRNAP, human mitochondrial RNA polymerase; lethargy; physical examination; shortness of breath.

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Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Admission Electrocardiogram Before, Remdesivir Administration, Demonstrates Normal Sinus Rhythm and Chronic Left Bundle Branch Block
Figure 2
Figure 2
Electrocardiogram During Remdesivir Treatment Demonstrates Sinus Bradycardia, Chronic Left Bundle Branch Block, Worsening QRS Complex Widening, and QTc Interval Prolongation
Figure 3
Figure 3
Electrocardiogram After Withdrawal of Remdesivir Demonstrates Normal Sinus Rhythm and Chronic Left Bundle Branch Block, With Resolution of QRS Complex Widening and QTc Interval Prolongation
See this image and copyright information in PMC

References

    1. Gordon C.J., Tchesnokov E.P., Woolner E. Remdesivir is a direct-acting antiviral that inhibits RNA-dependent RNA polymerase from severe acute respiratory syndrome coronavirus 2 with high potency. J Biol Chem. 2020;295:6785–6797. - PMC - PubMed
    1. Gilead Sciences . U.S. Food and Drug Administration; 2020. Remdesivir [package insert]
    1. Mulangu S., Dodd L.E., Davey R.T. A randomized, controlled trial of Ebola virus disease therapeutics. N Engl J Med. 2019;381:2293–2303. - PMC - PubMed
    1. Grein J., Ohmagari N., Shin D. Compassionate use of remdesivir for patients with severe Covid-19. N Engl J Med. 2020;382:2327–2336. - PMC - PubMed
    1. Wang Y., Zhang D., Du G. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2020;395:1569–1578. - PMC - PubMed

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