By vgreene, 27 May, 2020 <b>Study considerations:</b> primary outcome changed mid-study, but incl as secondary outcome; varied protocols for other COVID-19 tx; remote monitoring
By vgreene, 27 May, 2020 Primary outcome of time to recovery: RDV 10 days vs placebo 15 days (rate ratio 1.29, 95% CI 1.12-1.49); in pts w/ severe dz, RDV 11 days vs placebo 18 days (rate ratio 1.31, 95% CI 1.12-1.52); no difference if mech vent or ECMO (rate ratio 0.98, 95% CI 0
By vgreene, 27 May, 2020 Multinational, double-blind, RCT; 1,062 hospitalized pts (mean age 58.9y, 89% severe dz) received RDV 200 mg IV x1, then 100 mg daily (n=541) or placebo (n=521) for up to 10 days total; supportive care and other COVID-19 tx per protocol; median 9 days btw
By switaschek, 27 May, 2020 If drug rate control inadequate/sx persist, use rhythm control.6 If drug tx inadequate and rhythm control not achievable: AV node ablation6 + pacing
By switaschek, 27 May, 2020 If HF and rest/exercise HR not controlled w/ BB, CCB (in HFpEF) or digoxin (alone or combined): Consider amiodarone4
By switaschek, 27 May, 2020 If BB/CCB failure/intolerance, use digoxin/combos:4 Digoxin controls resting HR in HFrEF. Combine BB w/ other drugs, incl digoxin; titrate to avoid bradycardia. Digoxin may be combined w/ BB or CCB incl for HF pts (avoid CCB if HFrEF)
By switaschek, 27 May, 2020 Resting goal HR ≤80 per AHA/ACC, ≤110 per ESC (if asymptomatic w/ preserved LV systolic fxn, target HR ≤110 per AHA/ACC). Adjust to control rate during exertion