key: cord-0758199-vytwclr4
authors: Lucijanic, Marko; Bistrovic, Petra
title: Remdesivir associated bradycardia might be a sign of good prognosis in COVID-19 patients
date: 2022-01-06
journal: Clin Microbiol Infect
DOI: 10.1016/j.cmi.2021.12.017
sha: 77494595059d690abdc29d046adb0b2d71cb90e3
doc_id: 758199
cord_uid: vytwclr4

nan

We have read with great interest the recent comment by dr. Dauby considering cardiovascular sideeffects of remdesivir [1] that might question its role in the treatment of severe COVID-19 patients [2] . At the moment bradycardia is considered to be most frequent cardiovascular side-effect of remdesivir and occurs due to undisclosed mechanism. However, as recently shown, COVID-19 patients developing bradycardia during remdesivir treatment experience more favorable disease course with less respiratory deterioration and less deaths, phenomenon independent of COVID-19 disease severity, age and comorbidity burden [3] . It can be speculated that patients able to develop bradycardia might have less sympathetic-adrenergic stimulation or higher concentration of specific drug metabolites having both antiviral and chronotropic effects. Thus, although being the most frequent "adverse" cardiovascular side-effect of remdesivir, bradycardia can be considered as desirable feature and a sign of good prognosis, but certainly mandates increased measures of patient surveillance. It should be noted that other reported potentially severe cardiovascular side-effects [4] are of uncertain clinical significance and it is unknown to what extent they would reflect on clinical outcomes in large cohorts of patients (i.e. do potential risks outweigh the benefits of remdesivir use). Certainly, COVID-19 patients who would benefit the most from or need to avoid remdesivir are yet to be recognized by future studies that are highly needed.

Funding: none

ESCMID COVID-19 living guidelines: drug treatment and clinical management

ESCMID COVID-19 Living guidelines: drug treatment and clinical management

Bradycardia during remdesivir treatment might be associated with improved survival in patients with COVID-19: a retrospective cohort study on 473 patients from a tertiary centre

Remdesivir might induce changes in electrocardiogram beyond bradycardia in patients with coronavirus disease 2019-The pilot study

Access to data: not applicable Contribution: ML and PB drafted the comment, revised if for critical content and approved the final version