Authors
- Petra Bistrović — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-3650-3297
- Marko Lucijanić — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-1372-2040
- Šime Manola — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-6444-2674
Keywords
remdesivir, atrial fibrillation, COVID-19
DOI
https://doi.org/10.15836/ccar2022.172Full Text
**Introduction**: Antiviral drug remdesivir used in treatment of COVID-19 has been observed to have cardiovascular side effects, most commonly sinus bradycardia (1). Previously published research suggests bradycardia caused by remdesivir might be a positive effect (2). Our research aims to investigate impacts of remdesivir use in patients with atrial fibrillation (AF). **Patients and Methods**: Our study included 5959 consecutively hospitalized severe and critical COVID-19 patients among which 876 received remdesivir with 876 matched controls. We compared the primary outcome, in-hospital death, in remdesivir treated AF patients compared to AF patients without treatment. **Results**: 188 (10.4%) of analyzed 1752 patients had AF, with prevalence comparable between groups (10% in remdesivir group vs 11,4% in control group). Overall, while patients with atrial fibrillation experienced significantly worse mortality compared to those without (50.5% vs 29.2%, p<0.001), when treated with remdesivir, the increased mortality was significantly smaller (43.2 vs 27.7%, OR 1.98, P<0.001) compared to the AF patients in the untreated group (57 vs 30.8%, OR 2.97, p<0.001), however these benefits were not evident in those requiring high flow oxygen therapy or mechanical ventilation at beginning of treatment. **Conclusion**: Atrial fibrillation is associated with increased mortality in severe and critical COVID-19, however early application of remdesivir might improve survival in this patient subgroup. Additional research is required to improve treatment.
Literature
- Touafchia A, Bagheri H, Carrié D, Durrieu G, Sommet A, Chouchana L, et al. Serious bradycardia and remdesivir for coronavirus 2019 (COVID-19): a new safety concerns. Clin Microbiol Infect. 2021 February 27;27(5):791.e5–8. https://doi.org/10.1016/j.cmi.2021.02.013
- Bistrovic P, Manola S, Lucijanic M. 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. Postgrad Med J. 2022 July;98(1161):501–2. https://doi.org/10.1136/postgradmedj-2021-141079
