Table 1:

Reports of sinus bradycardia in patients with COVID-19 receiving remdesivir

StudyAge, yr; sexBradycardia onset relative to remdesivir initiationRisk factors for bradycardiaLowest heart rate, BPMOther ECG abnormalitiesClinical sequelaeTime to recovery after drug discontinuation
Gupta et al.826; FDay 2, nadir on day 3None40Prolonged QT/QTc to 628/555 ms* (from 388/439 ms) with T-wave abnormalitiesAsymptomaticWithin 48–72 h
Gupta et al.877; FDay 3Age48NoneAsymptomaticWithin 48 h
Sanchez-Codez et al.513; MDay 3None40NoneAsymptomaticWithin 24 h
Gubitosa et al.754; FDay 2, nadir on day 4None34QRS widening to 170 ms (from 168 ms before administration and 150 ms baseline) and QTc prolongation to 496 ms (from 440–460 ms)Angina and hypotension requiring atropineWithin 4 d
Current case59; MDay 3None50NoneAsymptomaticWithin 72 h
  • Note: BPM = beats per minute, ECG = electrocardiogram.

  • * On azithromycin until the day before discontinuation of remdesivir.

  • From correspondence with Gubitosa et al., Feb. 2021 (Dr. James Gubitosa [Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey]: personal communication, 2021).