Review Article

Remdesivir-Induced Bradycardia

Authors: Sai Gautham Kanagala, MBBS, Hardeep Dholiya, MBBS, Poonam Jhajj, BS, Meet A. Patel, MBBS, Vasu Gupta, MBBS, Sachin Gupta, MD, Shiau-ing Wu, MD, Rohit Jain, MD


Remdesivir, a viral RNA–dependent RNA polymerase inhibitor, found extensive use in coronavirus disease 2019–infected patients because it curbs the viral load expansion. Among patients hospitalized as a result of lower respiratory tract infection, remdesivir proved to improve recovery time; however, remdesivir also can induce significant cytotoxic effects on cardiac myocytes. In this narrative review, we discuss the pathophysiological mechanism of remdesivir-induced bradycardia and diagnostic and management strategies for these patients. We conclude that further research is necessary to understand better the mechanism of bradycardia in coronavirus disease 2019 patients with or without cardiovascular disorder treated with remdesivir.

Posted in: Infectious Disease111

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Fig. 1. Remdesivir-induced bradycardia: case distribution according to sex.

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Fig. 2. Remdesivir-induced bradycardia: case distribution according to age.

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Fig. 3. Adenosine-mediated negative chronotropic effect. A1, adenosine; SA, sinoatrial.

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