Nebulized enriched heparin improves respiratory parameters in patients with COVID-19: a phase I/II randomized and triple-blind clinical trial

Bibliographic Details
Main Author: Ramos da Silva Grillo, Vinicius Tadeu [UNESP]
Publication Date: 2024
Other Authors: Bertanha, Matheus [UNESP], da Silva Rodrigues, Lenize [UNESP], de Lima, Marcelo Andrade, Mellucci Filho, Pedro Luciano [UNESP], Rahal Guaragna Machado, Rafael, Durigon, Edson Luiz, Dias Sertorio, Nathália [UNESP], de Assis Golim, Marjorie [UNESP], Moroz, Andrei [UNESP], Marques Braz, Aline Márcia [UNESP], de Moraes, Leonardo Nazário [UNESP], Leite, Marco Antonio [UNESP], Bonciani Nader, Helena, de Campos, Gustavo Constantino, Rodrigues Guzzo Carvalho, Cristiane, Florença Cardoso, Fábio [UNESP], Magro, Angelo José [UNESP], Caputo Nunes, Helga, Tommasini Grotto, Rejane Maria [UNESP], de Cássia Alvarado, Rita [UNESP], de Moura Campos Pardini, Maria Inês [UNESP], Lima Sobreira, Marcone [UNESP], da Costa, Erika Alessandra Pellison Nunes [UNESP], Naime Barbosa, Alexandre [UNESP], Fortaleza, Carlos Magno Castelo Branco [UNESP]
Format: Article
Language: eng
Source: Repositório Institucional da UNESP
Download full: http://dx.doi.org/10.1038/s41598-024-70064-8
https://hdl.handle.net/11449/302870
Summary: To evaluate the safety and the potential antiviral treatment of inhaled enriched heparin in patients with COVID-19. The specific objectives were to investigate the anticoagulation profile, antiviral and anti-inflammatory effects, and respiratory evolution of inhaled enriched heparin. We conducted a randomized, triple-blind, placebo-controlled Phase I/II clinical trial in hospitalized adults with COVID-19 receiving inhalation of enriched heparin or saline (placebo) every 4 h for 7 days. Among the 27 patients who completed the study, no changes in blood coagulation parameters were observed, indicating the safety of inhaled enriched heparin. The group receiving enriched heparin showed a significant reduction in the need for supplemental oxygen and improvement in respiratory parameters, such as the PaO2/FiO2 ratio. Inhalation of enriched heparin is shown to be safe and has also demonstrated potential therapeutic benefits for patients with COVID-19. These promising results justify the continuation of the study to the next phase, Phase II/III, to further evaluate the therapeutic efficacy of inhaled enriched heparin in the treatment of COVID-19-associated viral pneumonia. Trial registration: ClinicalTrials.gov. 08/02/2021. Identifier: NCT04743011.
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spelling Nebulized enriched heparin improves respiratory parameters in patients with COVID-19: a phase I/II randomized and triple-blind clinical trialCOVID-19Enriched heparinSafetySARS-CoV-2TreatmentTo evaluate the safety and the potential antiviral treatment of inhaled enriched heparin in patients with COVID-19. The specific objectives were to investigate the anticoagulation profile, antiviral and anti-inflammatory effects, and respiratory evolution of inhaled enriched heparin. We conducted a randomized, triple-blind, placebo-controlled Phase I/II clinical trial in hospitalized adults with COVID-19 receiving inhalation of enriched heparin or saline (placebo) every 4 h for 7 days. Among the 27 patients who completed the study, no changes in blood coagulation parameters were observed, indicating the safety of inhaled enriched heparin. The group receiving enriched heparin showed a significant reduction in the need for supplemental oxygen and improvement in respiratory parameters, such as the PaO2/FiO2 ratio. Inhalation of enriched heparin is shown to be safe and has also demonstrated potential therapeutic benefits for patients with COVID-19. These promising results justify the continuation of the study to the next phase, Phase II/III, to further evaluate the therapeutic efficacy of inhaled enriched heparin in the treatment of COVID-19-associated viral pneumonia. Trial registration: ClinicalTrials.gov. 08/02/2021. Identifier: NCT04743011.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Royal SocietyAcademy of Medical SciencesDepartment of Surgery and Orthopedics Botucatu Medical School São Paulo State University – UNESP Clinical Hospital, Professor Montenegro Avenue, SPApplied Biotechnology Laboratory Research Nucleus of Clinical Hospital Botucatu Medical School São Paulo State University – UNESP, SPCentre for Glycoscience School of Life Sciences Keele University, StaffordshireDepartment of Microbiology Institute of Biomedical Sciences University of Sao Paulo - USPScientific Platform Pasteur USP (SPPU) University of São PauloDepartment of Bioprocess and Biotechnology School of Pharmaceutical Sciences São Paulo State University – UNESP, SPClinical Hospital of the Botucatu Medical School São Paulo State University – UNESP, SPDepartment of Biochemistry Federal University of São Paulo – UNIFESP, SPDepartment of Orthopedics and Traumatology School of Medical Sciences University of Campinas – UNICAMP, SPDepartment of Biophysics and Pharmacology Institute of Biosciences São Paulo State University – UNESP, SPTeaching and Research Center of the Albert Einstein Hospital, SPBioprocessing and Biotechnology Department School of Agriculture São Paulo State University – UNESP, SPInternal Medicine Division Botucatu Medical School São Paulo State University – UNESP, SPDepartment of Infectious Diseases Botucatu Medical School São Paulo State University – UNESP, SPDepartment of Surgery and Orthopedics Botucatu Medical School São Paulo State University – UNESP Clinical Hospital, Professor Montenegro Avenue, SPApplied Biotechnology Laboratory Research Nucleus of Clinical Hospital Botucatu Medical School São Paulo State University – UNESP, SPDepartment of Bioprocess and Biotechnology School of Pharmaceutical Sciences São Paulo State University – UNESP, SPClinical Hospital of the Botucatu Medical School São Paulo State University – UNESP, SPDepartment of Biophysics and Pharmacology Institute of Biosciences São Paulo State University – UNESP, SPBioprocessing and Biotechnology Department School of Agriculture São Paulo State University – UNESP, SPInternal Medicine Division Botucatu Medical School São Paulo State University – UNESP, SPDepartment of Infectious Diseases Botucatu Medical School São Paulo State University – UNESP, SPFAPESP: 2020/12165-8Royal Society: IEC\NSFC\201116Academy of Medical Sciences: SBF007\100054Universidade Estadual Paulista (UNESP)Keele UniversityUniversidade de São Paulo (USP)Universidade Estadual de Campinas (UNICAMP)Teaching and Research Center of the Albert Einstein HospitalRamos da Silva Grillo, Vinicius Tadeu [UNESP]Bertanha, Matheus [UNESP]da Silva Rodrigues, Lenize [UNESP]de Lima, Marcelo AndradeMellucci Filho, Pedro Luciano [UNESP]Rahal Guaragna Machado, RafaelDurigon, Edson LuizDias Sertorio, Nathália [UNESP]de Assis Golim, Marjorie [UNESP]Moroz, Andrei [UNESP]Marques Braz, Aline Márcia [UNESP]de Moraes, Leonardo Nazário [UNESP]Leite, Marco Antonio [UNESP]Bonciani Nader, Helenade Campos, Gustavo ConstantinoRodrigues Guzzo Carvalho, CristianeFlorença Cardoso, Fábio [UNESP]Magro, Angelo José [UNESP]Caputo Nunes, HelgaTommasini Grotto, Rejane Maria [UNESP]de Cássia Alvarado, Rita [UNESP]de Moura Campos Pardini, Maria Inês [UNESP]Lima Sobreira, Marcone [UNESP]da Costa, Erika Alessandra Pellison Nunes [UNESP]Naime Barbosa, Alexandre [UNESP]Fortaleza, Carlos Magno Castelo Branco [UNESP]2025-04-29T19:27:58Z2024-12-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1038/s41598-024-70064-8Scientific Reports, v. 14, n. 1, 2024.2045-2322https://hdl.handle.net/11449/30287010.1038/s41598-024-70064-82-s2.0-85202187865Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengScientific Reportsinfo:eu-repo/semantics/openAccess2025-05-01T05:32:33Zoai:repositorio.unesp.br:11449/302870Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestrepositoriounesp@unesp.bropendoar:29462025-05-01T05:32:33Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv Nebulized enriched heparin improves respiratory parameters in patients with COVID-19: a phase I/II randomized and triple-blind clinical trial
title Nebulized enriched heparin improves respiratory parameters in patients with COVID-19: a phase I/II randomized and triple-blind clinical trial
spellingShingle Nebulized enriched heparin improves respiratory parameters in patients with COVID-19: a phase I/II randomized and triple-blind clinical trial
Ramos da Silva Grillo, Vinicius Tadeu [UNESP]
COVID-19
Enriched heparin
Safety
SARS-CoV-2
Treatment
title_short Nebulized enriched heparin improves respiratory parameters in patients with COVID-19: a phase I/II randomized and triple-blind clinical trial
title_full Nebulized enriched heparin improves respiratory parameters in patients with COVID-19: a phase I/II randomized and triple-blind clinical trial
title_fullStr Nebulized enriched heparin improves respiratory parameters in patients with COVID-19: a phase I/II randomized and triple-blind clinical trial
title_full_unstemmed Nebulized enriched heparin improves respiratory parameters in patients with COVID-19: a phase I/II randomized and triple-blind clinical trial
title_sort Nebulized enriched heparin improves respiratory parameters in patients with COVID-19: a phase I/II randomized and triple-blind clinical trial
author Ramos da Silva Grillo, Vinicius Tadeu [UNESP]
author_facet Ramos da Silva Grillo, Vinicius Tadeu [UNESP]
Bertanha, Matheus [UNESP]
da Silva Rodrigues, Lenize [UNESP]
de Lima, Marcelo Andrade
Mellucci Filho, Pedro Luciano [UNESP]
Rahal Guaragna Machado, Rafael
Durigon, Edson Luiz
Dias Sertorio, Nathália [UNESP]
de Assis Golim, Marjorie [UNESP]
Moroz, Andrei [UNESP]
Marques Braz, Aline Márcia [UNESP]
de Moraes, Leonardo Nazário [UNESP]
Leite, Marco Antonio [UNESP]
Bonciani Nader, Helena
de Campos, Gustavo Constantino
Rodrigues Guzzo Carvalho, Cristiane
Florença Cardoso, Fábio [UNESP]
Magro, Angelo José [UNESP]
Caputo Nunes, Helga
Tommasini Grotto, Rejane Maria [UNESP]
de Cássia Alvarado, Rita [UNESP]
de Moura Campos Pardini, Maria Inês [UNESP]
Lima Sobreira, Marcone [UNESP]
da Costa, Erika Alessandra Pellison Nunes [UNESP]
Naime Barbosa, Alexandre [UNESP]
Fortaleza, Carlos Magno Castelo Branco [UNESP]
author_role author
author2 Bertanha, Matheus [UNESP]
da Silva Rodrigues, Lenize [UNESP]
de Lima, Marcelo Andrade
Mellucci Filho, Pedro Luciano [UNESP]
Rahal Guaragna Machado, Rafael
Durigon, Edson Luiz
Dias Sertorio, Nathália [UNESP]
de Assis Golim, Marjorie [UNESP]
Moroz, Andrei [UNESP]
Marques Braz, Aline Márcia [UNESP]
de Moraes, Leonardo Nazário [UNESP]
Leite, Marco Antonio [UNESP]
Bonciani Nader, Helena
de Campos, Gustavo Constantino
Rodrigues Guzzo Carvalho, Cristiane
Florença Cardoso, Fábio [UNESP]
Magro, Angelo José [UNESP]
Caputo Nunes, Helga
Tommasini Grotto, Rejane Maria [UNESP]
de Cássia Alvarado, Rita [UNESP]
de Moura Campos Pardini, Maria Inês [UNESP]
Lima Sobreira, Marcone [UNESP]
da Costa, Erika Alessandra Pellison Nunes [UNESP]
Naime Barbosa, Alexandre [UNESP]
Fortaleza, Carlos Magno Castelo Branco [UNESP]
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidade Estadual Paulista (UNESP)
Keele University
Universidade de São Paulo (USP)
Universidade Estadual de Campinas (UNICAMP)
Teaching and Research Center of the Albert Einstein Hospital
dc.contributor.author.fl_str_mv Ramos da Silva Grillo, Vinicius Tadeu [UNESP]
Bertanha, Matheus [UNESP]
da Silva Rodrigues, Lenize [UNESP]
de Lima, Marcelo Andrade
Mellucci Filho, Pedro Luciano [UNESP]
Rahal Guaragna Machado, Rafael
Durigon, Edson Luiz
Dias Sertorio, Nathália [UNESP]
de Assis Golim, Marjorie [UNESP]
Moroz, Andrei [UNESP]
Marques Braz, Aline Márcia [UNESP]
de Moraes, Leonardo Nazário [UNESP]
Leite, Marco Antonio [UNESP]
Bonciani Nader, Helena
de Campos, Gustavo Constantino
Rodrigues Guzzo Carvalho, Cristiane
Florença Cardoso, Fábio [UNESP]
Magro, Angelo José [UNESP]
Caputo Nunes, Helga
Tommasini Grotto, Rejane Maria [UNESP]
de Cássia Alvarado, Rita [UNESP]
de Moura Campos Pardini, Maria Inês [UNESP]
Lima Sobreira, Marcone [UNESP]
da Costa, Erika Alessandra Pellison Nunes [UNESP]
Naime Barbosa, Alexandre [UNESP]
Fortaleza, Carlos Magno Castelo Branco [UNESP]
dc.subject.por.fl_str_mv COVID-19
Enriched heparin
Safety
SARS-CoV-2
Treatment
topic COVID-19
Enriched heparin
Safety
SARS-CoV-2
Treatment
description To evaluate the safety and the potential antiviral treatment of inhaled enriched heparin in patients with COVID-19. The specific objectives were to investigate the anticoagulation profile, antiviral and anti-inflammatory effects, and respiratory evolution of inhaled enriched heparin. We conducted a randomized, triple-blind, placebo-controlled Phase I/II clinical trial in hospitalized adults with COVID-19 receiving inhalation of enriched heparin or saline (placebo) every 4 h for 7 days. Among the 27 patients who completed the study, no changes in blood coagulation parameters were observed, indicating the safety of inhaled enriched heparin. The group receiving enriched heparin showed a significant reduction in the need for supplemental oxygen and improvement in respiratory parameters, such as the PaO2/FiO2 ratio. Inhalation of enriched heparin is shown to be safe and has also demonstrated potential therapeutic benefits for patients with COVID-19. These promising results justify the continuation of the study to the next phase, Phase II/III, to further evaluate the therapeutic efficacy of inhaled enriched heparin in the treatment of COVID-19-associated viral pneumonia. Trial registration: ClinicalTrials.gov. 08/02/2021. Identifier: NCT04743011.
publishDate 2024
dc.date.none.fl_str_mv 2024-12-01
2025-04-29T19:27:58Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1038/s41598-024-70064-8
Scientific Reports, v. 14, n. 1, 2024.
2045-2322
https://hdl.handle.net/11449/302870
10.1038/s41598-024-70064-8
2-s2.0-85202187865
url http://dx.doi.org/10.1038/s41598-024-70064-8
https://hdl.handle.net/11449/302870
identifier_str_mv Scientific Reports, v. 14, n. 1, 2024.
2045-2322
10.1038/s41598-024-70064-8
2-s2.0-85202187865
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Scientific Reports
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv Scopus
reponame:Repositório Institucional da UNESP
instname:Universidade Estadual Paulista (UNESP)
instacron:UNESP
instname_str Universidade Estadual Paulista (UNESP)
instacron_str UNESP
institution UNESP
reponame_str Repositório Institucional da UNESP
collection Repositório Institucional da UNESP
repository.name.fl_str_mv Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)
repository.mail.fl_str_mv repositoriounesp@unesp.br
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