Torsades de Pointes Fueled by COVID-19, Aggravated by Remdesivir

Research Article

Abstract

The COVID-19 pandemic has unveiled numerous cardiovascular complications, among which Torsades de Pointes (TdP) stands out as a life-threatening arrhythmia. Remdesivir, a commonly used antiviral for COVID-19, has been implicated in significant cardiovascular adverse effects, including QTc prolongation.

We present an elderly female with COVID-19 pneumonia who developed TdP after remdesivir therapy. Despite treatment with magnesium sulfate and discontinuation of remdesivir, she experienced recurrent TdP, culminating in cardiac arrest.

Arrhythmias are significant complications of COVID-19, particularly in ICU patients. Hypoxia, myocardial inflammation, and viral effects on ion channel regulation may independently predispose patients to QTc prolongation. Remdesivir has been identified as a torsadogenic agent, warranting QT interval monitoring during therapy. This underscores the need for vigilant cardiac monitoring and further investigation into the cardiovascular risks associated with COVID-19 and its treatments. This case emphasizes the critical intersection of COVID-19 infection and its therapeutic interventions in the pathogenesis of TdP.