Remdesivir-Induced Bradycardia

Abstract

Remdesivir inhibits the viral RNA–dependent RNA polymerase, thereby interrupting the viral replication process. It decreases the time to recovery in hospitalized coronavirus disease 2019 patients with lower respiratory tract infections; however, older adult patients with underlying cardiovascular disease and those taking beta-blockers, when treated with remdesivir, have bradycardia as an adverse effect. This article provides a brief overview of remdesivir-induced bradycardia, diagnosis, and treatment.

Abstract

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.