Gholipour Mahboobeh, Samidoost Pirooz, Moayerifar Mani, Ghasemzadeh Golshan
Department of Cardiology, Healthy Heart Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Department of Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran.
SAGE Open Med Case Rep. 2024 Feb 20;12:2050313X241233432. doi: 10.1177/2050313X241233432. eCollection 2024.
Remdesivir is a nucleotide prodrug of an adenosine analog. It binds to the viral Ribonucleic Acid (RNA)-dependent RNA polymerase and inhibits viral replication by terminating RNA transcription prematurely. Remdesivir has demonstrated in vitro and in vivo activity against Severe Acute Respiratory Syndrome Coronavirus 2; it also acts in vitro neutralization activity against the Omicron variant and its subvariants. We reported a 54-years-old woman admitted with Coronavirus disease 2019. Considering to require a high fraction of inspired oxygen therapy (⩾0.6) and based on lung high resolution computed tomography, Remdesivir therapy was ordered for 5 days. She experienced palpitations and dizziness 2 days after starting Remdesivir therapy. Her QTc interval was prolonged on the electrocardiogram without any significant electrolyte abnormalities or concomitant use of medications. Although the cardiac side effects of Remdesivir therapy have been well documented, in a few cases reported the association between Remdesivir therapy and QTc interval prolongation. Since, QTc interval prolongation has the potential risk of sudden cardiac death, the clinicians should be aware of mentioned association and check electrocardiogram daily, as well as other laboratory exams.
瑞德西韦是一种腺苷类似物的核苷酸前药。它与病毒核糖核酸(RNA)依赖性RNA聚合酶结合,并通过过早终止RNA转录来抑制病毒复制。瑞德西韦已在体外和体内显示出对严重急性呼吸综合征冠状病毒2的活性;它在体外对奥密克戎变种及其亚变种也具有中和活性。我们报告了一名54岁的女性因2019冠状病毒病入院。考虑到需要高比例的吸氧治疗(⩾0.6),并基于肺部高分辨率计算机断层扫描结果,医嘱给予瑞德西韦治疗5天。她在开始瑞德西韦治疗2天后出现心悸和头晕。她的心电图显示QTc间期延长,无任何明显的电解质异常或同时使用其他药物。尽管瑞德西韦治疗的心脏副作用已有充分记录,但在少数病例中报告了瑞德西韦治疗与QTc间期延长之间的关联。由于QTc间期延长有潜在的心脏性猝死风险,临床医生应意识到上述关联,并每日检查心电图以及其他实验室检查。