Glycine by enteral route does not improve major clinical outcomes in severe COVID-19: a randomized clinical pilot trial.

Autor: Vargas MH; Departamento de Investigación en Hiperreactividad Bronquial, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calzada de Tlalpan 4502, CP 14080, Ciudad de México, México. mhvargasb@yahoo.com.mx., Chávez J; Departamento de Investigación en Hiperreactividad Bronquial, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calzada de Tlalpan 4502, CP 14080, Ciudad de México, México., Del-Razo-Rodríguez R; Servicio Clínico de Neumología Pediátrica, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, México., Muñoz-Perea C; Servicio de Urgencias, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, México., Romo-Domínguez KJ; Servicio de Urgencias, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, México.; Servicio de Neumología, Hospital Infantil del Estado de Sonora, Hermosillo, Sonora, México., Báez-Saldaña R; Servicio Clínico 3, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, México., Rumbo-Nava U; Servicio Clínico 3, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, México., Guerrero-Zúñiga S; Unidad de Medicina del Sueño, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, México.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 May 21; Vol. 14 (1), pp. 11566. Date of Electronic Publication: 2024 May 21.
DOI: 10.1038/s41598-024-62321-7
Abstrakt: There is a worrying scarcity of drug options for patients with severe COVID-19. Glycine possesses anti-inflammatory, cytoprotective, endothelium-protective, and platelet-antiaggregant properties, so its use in these patients seems promising. In this open label, controlled clinical trial, inpatients with severe COVID-19 requiring mechanical ventilation randomly received usual care (control group) or usual care plus 0.5 g/kg/day glycine by the enteral route (experimental group). Major outcomes included mortality, time to weaning from mechanical ventilation, total time on mechanical ventilation, and time from study recruitment to death. Secondary outcomes included laboratory tests and serum cytokines. Patients from experimental (n = 33) and control groups (n = 23) did not differ in basal characteristics. There were no differences in mortality (glycine group, 63.6% vs control group, 52.2%, p = 0.60) nor in any other major outcome. Glycine intake was associated with lower fibrinogen levels, either evaluated per week of follow-up (p < 0.05 at weeks 1, 2, and 4) or as weighted mean during the whole hospitalization (608.7 ± 17.7 mg/dl vs control 712.2 ± 25.0 mg/dl, p = 0.001), but did not modify any other laboratory test or cytokine concentration. In summary, in severe COVID-19 glycine was unable to modify major clinical outcomes, serum cytokines or most laboratory tests, but was associated with lower serum fibrinogen concentration.Registration: ClinicalTrials.gov NCT04443673, 23/06/2020.
(© 2024. The Author(s).)
Databáze: MEDLINE
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