Background: Remdesivir is effective against SARS-Cov-2 with little evidence of its adverse effect on the cardiac system. The aim of the present study is investigating the incidence of bradycardia in COVID-19 patients treated with Remdesivir.Methods: This prospective longitudinal study was conducted in a tertiary center on COVID-19 patients for Remdesivir therapy. The objectives were to investigate the incidence of sinus bradycardia, and also the association between their demographics, underlying diseases, and the disease severity with developing bradycardia in COVID-19 patients treated with Remdesivir.Results: Of 177 patients, 44% were male. The mean (±standard deviation) age of patients was 49.79 ± 15.16 years old. Also, 33% were hospitalized due to more severe symptoms. Oxygen support was required for all hospitalized subjects. A total of 40% of the patients had comorbidities, with the most common comorbidity being hypertension. The overall incidence of bradycardia (heart rate<60 bpm) in patients receiving Remdesivir was 27%, of whom 70% had extreme bradycardia (heart rate <50 bpm). There was also a statistically significant reduction in heart rate after five doses of Remdesivir compared to the baseline heart rates. In the multivariable model, none of the covariates including age above 60 years, female sex, CRP>50 mg/L, O2 saturation<90%, underlying cardiovascular disease, hypertension and diabetes mellitus, and beta-blockers were associated with Remdesivir-induced bradycardia. No association was found between the COVID-19 severity indicators and bradycardia.Conclusion: As sinus bradycardia is a prevalent adverse cardiac effect of Remdesivir, it is recommended that all COVID-19 patients receiving Remdesivir, be evaluated for heart rate based on examination; and in the case of bradyarrhythmia, cardiac monitoring should be performed during administration to prevent adverse drug reactions.

COVID-19 pandemic and the confusion of the world at the beginning of the epidemic affected many aspects of the life and health care. In this regard, organ donation as a vital approach for life saving in patients on the waiting list was influenced too. This essential treatment requires the provision of vital organs from the brain death cases, which is a sensitive, accurate and lengthy process. This process begins with the identification of Glasgow Coma Scale (GCS) cases less than five and is followed by organ harvesting and assignment to waiting list patients. Organ donation and factors related to its process have been fluctuated during three specific time periods, including the first and second year of the epidemic with the year before the epidemic. This decrease in the number of donations has been felt worldwide and it has been reported that this number has decreased significantly even in the amount of blood donation. Numerous barriers to the treatment system during the epidemic, limitations of surgeries except in emergencies, asymptomatic patients, and many unknown aspects of the disease have shown that the policies and approaches of procurement centers need to be changed to continue efforts in this situation. New protocols (according to the needs of these days) should be developed and implemented according to the conditions ahead.

Background: In our organ procurement unit, we use three different strategies to identify all potential brain death donors. So we aimed to evaluate the incentives and deterrents in the process of donor identification based on hospital characteristics. Methods: In the electronic, cross-sectional study, a 16-item questionnaire that includes information regarding hospital characteristics (having a transplant and neurosurgery ward), being related to an organization versus general or private hospital, and also medical staff experience about the donation process and their attitude about donor identification. Items related to the donor identification were nine questions about the potential facilitators as well as seven items corresponding to the potential barriers. Results: Two-hundred-thirty nurses and medical staff with a mean age of 38.5±28 years participated in the study, of which 62.3% (n=143) were female. In the type I hospitals, 12.4% of respondents believed that hospital policies were weak in identifying potential identifiers, and in type II hospitals, 21.7% agreed that these policies were weak. While 35.9% and 42.2% of them in type I and II hospitals, respectively, believed that the hospital's policies are strong and acceptable, P=0.04. The main facilitator was active detection via regular phone calls which were mentioned by 65.2%. Donor detection by in-hospital coordinators was in second place (42.7%). Also, the availability of the donor coordinators and visiting by the inspectors were other important motivations for donor detection. Regarding barriers, staff viewpoints toward donor selection affect the donor referral to the OPU (54.7%) and staff opinions that this process would be distressing to the donor family avoids donor identification (47.1%). Moreover, concerns about patient care were another notable obstacle (43.1%). Conclusions: It is important to use phone calls for better coverage of donation and also train medical staff to improve their ability in donor selection.

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