Sinus Bradycardia Associated with Remdesivir Treatment in COVID-19: A Case Report and Literature Review

Abstract

BACKGROUND: Although remdesivir treatment is widely used during the pandemic coronavirus disease 2019 (COVID-19), there is scarce evidence regarding its cardiac side effects. CASE PRESENTATION: We report the case of a 36-year-old male hospitalized due to severe COVID-19 symptoms. He presented with a 10-day history of fever (up to 39.7 °C), productive cough, hemoptysis, fatigue, myalgias and hypoxemia. The patient received supplemental oxygen, dexamethasone, remdesivir and empirical antibiotic treatment according to protocol. Asymptomatic sinus bradycardia developed on hospital day 3 (namely, heart rate 39/min compared to 92/min on admission). Secondary causes of bradycardia were excluded based on the absence of relevant evidence from laboratory work-up and echocardiographic examination. The patient's rhythm restored to normal 9 days after the discontinuation of remdesivir. CONCLUSIONS: Considering the frequent use of remdesivir in patients with COVID-19, physicians should be aware of this possible adverse event.