key: cord-0896813-hpjr2lrp
authors: Barkas, Fotios; Bechlioulis, Aris; Liberopoulos, Evangelos
title: Bradycardia and coronavirus disease 2019: What is behind?
date: 2021-07-30
journal: Clin Cardiol
DOI: 10.1002/clc.23701
sha: 3d886be4e0ae7916738fd5931d69a8e387618c67
doc_id: 896813
cord_uid: hpjr2lrp

nan

To the Editor,

We read with interest the paper by Kumar Corticosteroids, remdesivir, tocilizumab, and anakinra are the commonly used drugs in hospitalized patients with COVID-19. 4, 5 Among them, remdesivir has been previously associated with bradycardia. 6, 7 Mitochondrial dysfunction prompted by the strong affinity of remdesivir for human mitochondrial RNA polymerase (h-mtRNAP), along with atrioventricular nodal inhibition due to its resemblance with adenosine, could be potential mechanisms. 7 Kumar et al. reported that 28.7% of patients treated with remdesivir developed an absolute bradycardic response. 1 In this regard, a formal statistical comparison between patients on versus off remdesivir would be useful in determining whether this medication was associated with increased bradycardia risk in their study. Moreover, the association of day of remdesivir administration with bradycardia diagnosis should be explored. Finally, it would be quite interesting if the authors investigated any association between remdesivir-associated bradycardia and mortality.

Bradycardia is frequent and clinically relevant in patients with COVID-19. Additional studies are needed to elucidate its underlying pathophysiological mechanisms.

A novel study on SARS-COV-2 virus associated bradycardia as a predictor of mortality-retrospective multicenter analysis

Potential effects of coronaviruses on the cardiovascular system: a review

Arrhythmias and COVID-19: a review

COVID-19) Treatment Guidelines. National Institutes of Health

Anakinra in hospitalized non-intubated patients with coronavirus disease 2019: a systematic review and meta-analysis

Serious bradycardia and remdesivir for coronavirus 2019 (COVID-19): a new safety concerns

Sinus Bradycardia associated with Remdesivir treatment in COVID-19: a case report and literature review