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Early Effects of Low Molecular Weight Heparin Therapy with Soft-Mist Inhaler for COVID-19-Induced Hypoxemia: A Phase IIb Trial

Abstract

In COVID-19-induced acute respiratory distress syndrome, the lungs are incapable of filling with sufficient air, leading to hypoxemia that results in high mortality among hospitalized patients. In clinical trials, low-molecular-weight heparin was administered via a specially designed soft-mist inhaler device in an investigator initiated, single-center, open-label, phase-IIb clinical trial. Patients with evidently worse clinical presentations were classed as the "Device Group"; 40 patients were given low-molecular-weight heparin via a soft mist inhaler at a dose of 4000 IU per administration, twice a day. The Control Group, also made up of 40 patients, received the standard therapy. The predetermined severity of hypoxemia and the peripheral oxygen saturation of patients were measured on the 1st and 10th days of treatment. The improvement was particularly striking in cases of severe hypoxemia. In the 10-day treatment, low-molecular-weight heparin was shown to significantly improve breathing capability when delivered via a soft-mist inhaler.

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References
1.
Yildiz-Pekoz A, Ozsoy Y . Inhaled Heparin: Therapeutic Efficacy and Recent Formulations. J Aerosol Med Pulm Drug Deliv. 2017; 30(3):143-156. DOI: 10.1089/jamp.2015.1273. View

2.
Rusnati M, Coltrini D, Oreste P, Zoppetti G, Albini A, Noonan D . Interaction of HIV-1 Tat protein with heparin. Role of the backbone structure, sulfation, and size. J Biol Chem. 1997; 272(17):11313-20. DOI: 10.1074/jbc.272.17.11313. View

3.
Tandon R, Sharp J, Zhang F, Pomin V, Ashpole N, Mitra D . Effective Inhibition of SARS-CoV-2 Entry by Heparin and Enoxaparin Derivatives. J Virol. 2020; 95(3). PMC: 7925120. DOI: 10.1128/JVI.01987-20. View

4.
Ghezzi S, Cooper L, Rubio A, Pagani I, Capobianchi M, Ippolito G . Heparin prevents Zika virus induced-cytopathic effects in human neural progenitor cells. Antiviral Res. 2017; 140:13-17. PMC: 7113768. DOI: 10.1016/j.antiviral.2016.12.023. View

5.
Guan M, Zeng X, Shi R, Zheng Y, Fan W, Su W . Aerosolization Performance, Antitussive Effect and Local Toxicity of Naringenin-Hydroxypropyl-β-Cyclodextrin Inhalation Solution for Pulmonary Delivery. AAPS PharmSciTech. 2021; 22(1):20. DOI: 10.1208/s12249-020-01889-5. View