Reversal of SARS-CoV2-Induced Hypoxia by Nebulized Sodium Ibuprofenate in a Compassionate Use Program

Autor: Lucia G. Guzmán, Celia S. Giler, Jorge L. Tambini Diaz, Germán D. Bueno, Marcelo Alejandro Beltrán, Leandro E. Peña Chiappero, Germán Ambasch, Javier A. Sala Mercado, Hernan A Perez, Carlos Martínez Picco, Néstor H. García, Daniela Josefina Porta, Galia I. Kalayan, Dario C. Quinodoz, Luis Alberto Argañarás, Esteban Coscia, Sonia E. Muñoz, Jorge O. Fandi, Pablo A. Doreski, Nicolás Martínez Ríos, Oscar Salva, Miriam A. Maldonado, Mauro A. Quiroga, Mariana N. Carrillo, Fernando Fournier, Dante M. Beltramo
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Infectious Diseases and Therapy
CONICET Digital (CONICET)
Consejo Nacional de Investigaciones Científicas y Técnicas
instacron:CONICET
ISSN: 2193-6382
2193-8229
Popis: Introduction: Sodium ibuprofenate in hypertonic saline (NaIHS) administered directly to the lungs by nebulization and inhalation has antibacterial and anti-inflammatory effects, with the potential to deliver these benefits to hypoxic patients. We describe a compassionate use program that offered this therapy to hospitalized COVID-19 patients. Methods: NaIHS (50 mg ibuprofen, tid) was provided in addition to standard of care (SOC) to hospitalized COVID-19 patients until oxygen saturation levels of > 94% were achieved on ambient air. Patients wore a containment hood to diminish aerosolization. Outcome data from participating patients treated at multiple hospitals in Argentina between April 4 and October 31, 2020, are summarized. Results were compared with a retrospective contemporaneous control (CC) group of hospitalized COVID-19 patients with SOC alone during the same time frame from a subset of participating hospitals from Córdoba and Buenos Aires. Results: The evolution of 383 patients treated with SOC + NaIHS [56 on mechanical ventilation (MV) at baseline] and 195 CC (21 on MV at baseline) are summarized. At baseline, NaIHS-treated patients had basal oxygen saturation of 90.7 ± 0.2% (74.3% were on supplemental oxygen at baseline) and a basal respiratory rate of 22.7 ± 0.3 breath/min. In the CC group, basal oxygen saturation was 92.6 ± 0.4% (52.1% were on oxygen supplementation at baseline) and respiratory rate was 19.3 ± 0.3 breath/min. Despite greater pulmonary compromise at baseline in the NaIHS-treated group, the length of treatment (LOT) was 9.1 ± 0.2 gs with an average length of stay (ALOS) of 11.5 ± 0.3 days, in comparison with an ALOS of 13.3 ± 0.9 days in the CC group. In patients on MV who received NaIHS, the ALOS was lower than in the CC group. In both NaIHS-treated groups, a rapid reversal of deterioration in oxygenation and NEWS2 scores was observed acutely after initiation of NaIHS therapy. No serious adverse events were considered related to ibuprofen therapy. Mortality was lower in both NaIHS groups compared with CC groups. Conclusions: Treatment of COVID-19 pneumonitis with inhalational nebulized NaIHS was associated with rapid improvement in hypoxia and vital signs, with no serious adverse events attributed to therapy. Nebulized NaIHS s worthy of further study in randomized, placebo-controlled trials (ClinicalTrials.gov: NCT04382768). Fil: Salva, Oscar. Clínica Independencia; Argentina Fil: Doreski, Pablo A.. Fundación Respirar; Argentina Fil: Giler, Celia S.. Clínica Independencia; Argentina Fil: Quinodoz, Dario C.. Sanatorio de la Cañada; Argentina Fil: Guzmán, Lucia G.. Sanatorio de la Cañada; Argentina Fil: Muñoz, Sonia Edith. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina Fil: Carrillo, Mariana Norma del Valle. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina Fil: Porta, Daniela Josefina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina Fil: Ambasch, Germán. Sanatorio Privado Mayo; Argentina Fil: Coscia, Esteban. Sanatorio Privado Mayo; Argentina Fil: Tambini Diaz, Jorge L.. Sanatorio Privado Mayo; Argentina Fil: Bueno, Germán D.. Sanatorio Privado Mayo; Argentina Fil: Fandi, Jorge O.. Clínica Independencia; Argentina Fil: Maldonado, Miriam A.. Sanatorio San Roque; Argentina Fil: Peña Chiappero, Leandro E.. Sanatori San Roque; Argentina Fil: Fournier, Fernando. Clínica Francesa; Argentina Fil: Pérez, Hernán A.. Sanatorio Alive; Argentina. University of Maryland; Estados Unidos Fil: Quiroga, Mauro A.. Instituto Modelo de Cardiología; Argentina Fil: Sala Mercado, Javier Agustin. Instituto Modelo de Cardiología; Argentina Fil: Martínez Picco, Carlos. Clínica del Sol; Argentina Fil: Beltrán, Marcelo Alejandro. Hospital Dr. Alberto Duhau; Argentina Fil: Castillo Argañarás, Luis Fernando. Hospital Dr. Alberto Duhau; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Ríos, Nicolás Martínez. Quimica Luar Srl; Argentina Fil: Kalayan, Galia I.. Provincia de Córdoba. Ministerio de Ciencia y Técnica. Centro de Excelencia en Productos y Procesos de Córdoba; Argentina Fil: Beltramo, Dante Miguel. Provincia de Córdoba. Ministerio de Ciencia y Técnica. Centro de Excelencia en Productos y Procesos de Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; Argentina Fil: Garcia, Nestor Horacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina. Provincia de Córdoba. Ministerio de Ciencia y Técnica. Centro de Excelencia en Productos y Procesos de Córdoba; Argentina
Databáze: OpenAIRE
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