부산대학교 도서관

Introduction: Previous studies have reported that COVID-19 infection-related bradycardia is a predictor of a poor prognosis. Remdesivir and tocilizumab were also reported as risk factors for bradycardia. In this study, we aimed to investigate the occurrence of bradycardia among COVID-19 patients and its potential relationship with mortality. Methods: Adult patients admitted to MacKay Memorial Hospital with COVID-19 infection from May to June 2021 were enrolled for analysis. Patients using medication for rate control, or who developed end-of-life bradycardia, were excluded. Bradycardia was defined as a persistent heart rate of fewer than 60 bpm on 2 separate occasions with a minimum 4-hour gap during hospitalization. Results: A total of 259 patients were included, and 75 (29%) experienced bradycardia during their hospitalization. Patients in the bradycardia group had a lower lymphocyte count, higher neutrophil/lymphocyte ratio, and increased GOT, GPT, LDH, ferritin, and CRP. Bradycardia was also related to more frequent use of systemic corticosteroids, remdesivir, tocilizumab, and enoxaparin. But after multiple logistic regression, only tocilizumab was recognized as a risk factor for bradycardia (odds ratio [OR]: 2.6512, 95% confidence interval [CI]: 1.3307-5.2823, p=0.0056). There was no significant difference in in-hospital mortality among patients with bradycardia using multivariate logistic regression analysis (OR: 1.0476, 95% CI: 0.3340-3.2857, p=0.9365). Conclusion: Bradycardia is a frequent phenomenon among hospitalized COVID-19 patients. Patients who had bradycardia events were more likely to receive tocilizumab, but not remdesivir treatment. Bradycardia events were not correlated with mortality in our patient group. Determining the mechanisms of bradycardia among COVID-19 patients requires further study.