Bradycardia associated with remdesivir treatment in coronavirus disease 2019 patients: A propensity score-matched analysis

DOI record: { "DOI": "10.1097/md.0000000000044501", "ISSN": [ "0025-7974", "1536-5964" ], "URL": "http://dx.doi.org/10.1097/MD.0000000000044501", "abstract": "<jats:p>Remdesivir is an antiviral drug recommended for the treatment of COVID-19. The therapeutic benefits of remdesivir remain under investigation, with further literature emerging regarding its cardiac side-effect profile. The objective of this study was to investigate the association of remdesivir with bradycardia using a propensity score-matched analysis. Secondary outcomes included assessing in-patient mortality and hospital length of stay following remdesivir treatment for COVID-19. A single-institution retrospective study investigating treatment with and without remdesivir in 645 patients admitted for COVID-19 management was performed. Following treatment with remdesivir, patients were analyzed for episodes of bradycardia, defined in this study as 2 consecutive episodes of a heart rate &lt;60 beats per minute. Matched cohorts were generated after controlling for potential confounders associated with remdesivir exposure. Subsequently, a propensity score-matched analysis was conducted to minimize selection bias and to account for the characteristics between the 2 comparison groups. In a sample of 645 COVID-19 patients, 58% were in the treatment group (Remdesivir+) and 42% were in the control group (Remdesivir-). 59% were males with a mean age of 57 ± 14.5 years. After propensity score matching, the remdesivir + group had a higher incidence of bradycardia (48.5% vs 30.7%, <jats:italic toggle=\"yes\">P</jats:italic> = .028). The remdesivir + group was found to have a lower rate of in-patient mortality (1.0% vs 3.0% <jats:italic toggle=\"yes\">P</jats:italic> &lt; .001) and longer in-patient length of stay (13.7 vs 6.3 days, <jats:italic toggle=\"yes\">P</jats:italic> &lt; .001) compared to the remdesivir- group. Patients with COVID-19 had a greater prevalence of bradycardia following treatment with remdesivir. For these patients, remdesivir reduced in-patient mortality compared with untreated COVID-19 patients.</jats:p>", "assertion": [ { "group": { "label": "Publication History", "name": "publication_history" }, "label": "Received", "name": "received", "value": "2024-10-21" }, { "group": { "label": "Publication History", "name": "publication_history" }, "label": "Accepted", "name": "accepted", "value": "2025-08-26" } ], "author": [ { "ORCID": "https://orcid.org/0000-0002-8881-5559", "affiliation": [ { "name": "Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV), NV" } ], "authenticated-orcid": false, "family": "Mohammed", "given": "Salman", "sequence": "first" }, { "affiliation": [ { "name": "Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV), NV" }, { "name": "Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH" } ], "family": "Bauzon", "given": "Justin", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Medical Education and Office of Research, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV" } ], "family": "Batra", "given": "Kavita", "sequence": "additional" }, { "affiliation": [ { "name": "Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV), NV" } ], "family": "Cosme", "given": "Celica", "sequence": "additional" }, { "affiliation": [ { "name": "Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV), NV" } ], "family": "Inciong", "given": "Kim", "sequence": "additional" }, { "affiliation": [ { "name": "Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV), NV" } ], "family": "Tian", "given": "Elli", "sequence": "additional" }, { "affiliation": [ { "name": "Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV), NV" } ], "family": "Azar", "given": "Fadi", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV." } ], "family": "Lee", "given": "Kevin", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV." } ], "family": "Houshmand", "given": "Nazanin", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV." } ], "family": "Pham", "given": "Uyen", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV." } ], "family": "Schreiber", "given": "Ariyon", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0002-7247-2213", "affiliation": [ { "name": "Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV." } ], "authenticated-orcid": false, "family": "Singh", "given": "Aditi", "sequence": "additional" 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