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Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial

COVID-19 is a fatal, fast-spreading pandemic, and numerous attempts are being made around the world to understand and manage the disease. COVID-19 patients may develop a cytokine-release syndrome, which causes serious respiratory diseases and, in many cases, death. The study examined the feasibility...

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Autores principales: Sarhan, Rania M., E. Altyar, Ahmed, Essam Abou Warda, Ahmed, Saied, Yasmine Mohamed, Ibrahim, Haytham Soliman Ghareeb, Schaalan, Mona F., Fathy, Shaimaa, Sarhan, Neven, Boshra, Marian S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10142327/
https://www.ncbi.nlm.nih.gov/pubmed/37111389
http://dx.doi.org/10.3390/ph16040631
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author Sarhan, Rania M.
E. Altyar, Ahmed
Essam Abou Warda, Ahmed
Saied, Yasmine Mohamed
Ibrahim, Haytham Soliman Ghareeb
Schaalan, Mona F.
Fathy, Shaimaa
Sarhan, Neven
Boshra, Marian S.
author_facet Sarhan, Rania M.
E. Altyar, Ahmed
Essam Abou Warda, Ahmed
Saied, Yasmine Mohamed
Ibrahim, Haytham Soliman Ghareeb
Schaalan, Mona F.
Fathy, Shaimaa
Sarhan, Neven
Boshra, Marian S.
author_sort Sarhan, Rania M.
collection PubMed
description COVID-19 is a fatal, fast-spreading pandemic, and numerous attempts are being made around the world to understand and manage the disease. COVID-19 patients may develop a cytokine-release syndrome, which causes serious respiratory diseases and, in many cases, death. The study examined the feasibility of employing legally available anti-inflammatory pentoxifylline (PTX), a low toxicity and cost medication, to mitigate the hyper-inflammation caused by COVID-19. Thirty adult patients who tested positive for SARS-CoV2 were hospitalized owing to the cytokine storm syndrome. They were given 400 mg of pentoxifylline orally TID according to the standard COVID-19 protocol of the Egyptian Ministry of Health. Besides this, a group of thirty-eight hospitalized COVID-19 patients who received the standard COVID-19 protocol was included in the study as a control group. The outcomes included laboratory test parameters, clinical improvements, and number of deaths in both groups. After receiving PTX, all patients showed a significant improvement in C reactive protein (CRP), and interleukin-6 (IL-6) levels at p < 0.01 and p = 0.004, respectively, while there was an increase in total leukocyte count (TLC) and neutrophil-to-leucocyte ratio (NLR) at p < 0.01 compared to their baseline levels. The D-dimer level showed a significant increase in the treatment group at p < 0.01, while showing no statistically significant difference in the control group. The median initial ALT (42 U/L) in the treatment group showed a decrease compared to the control group (51 U/L). No statistical significance was reported regarding clinical improvement, length of stay, and death percentages between the two groups. Our results showed no significant improvement of PTX over controls in clinical outcomes of hospitalized COVID-19 patients. Nevertheless, PTX displayed a positive effect on certain inflammatory biomarkers.
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spelling pubmed-101423272023-04-29 Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial Sarhan, Rania M. E. Altyar, Ahmed Essam Abou Warda, Ahmed Saied, Yasmine Mohamed Ibrahim, Haytham Soliman Ghareeb Schaalan, Mona F. Fathy, Shaimaa Sarhan, Neven Boshra, Marian S. Pharmaceuticals (Basel) Article COVID-19 is a fatal, fast-spreading pandemic, and numerous attempts are being made around the world to understand and manage the disease. COVID-19 patients may develop a cytokine-release syndrome, which causes serious respiratory diseases and, in many cases, death. The study examined the feasibility of employing legally available anti-inflammatory pentoxifylline (PTX), a low toxicity and cost medication, to mitigate the hyper-inflammation caused by COVID-19. Thirty adult patients who tested positive for SARS-CoV2 were hospitalized owing to the cytokine storm syndrome. They were given 400 mg of pentoxifylline orally TID according to the standard COVID-19 protocol of the Egyptian Ministry of Health. Besides this, a group of thirty-eight hospitalized COVID-19 patients who received the standard COVID-19 protocol was included in the study as a control group. The outcomes included laboratory test parameters, clinical improvements, and number of deaths in both groups. After receiving PTX, all patients showed a significant improvement in C reactive protein (CRP), and interleukin-6 (IL-6) levels at p < 0.01 and p = 0.004, respectively, while there was an increase in total leukocyte count (TLC) and neutrophil-to-leucocyte ratio (NLR) at p < 0.01 compared to their baseline levels. The D-dimer level showed a significant increase in the treatment group at p < 0.01, while showing no statistically significant difference in the control group. The median initial ALT (42 U/L) in the treatment group showed a decrease compared to the control group (51 U/L). No statistical significance was reported regarding clinical improvement, length of stay, and death percentages between the two groups. Our results showed no significant improvement of PTX over controls in clinical outcomes of hospitalized COVID-19 patients. Nevertheless, PTX displayed a positive effect on certain inflammatory biomarkers. MDPI 2023-04-21 /pmc/articles/PMC10142327/ /pubmed/37111389 http://dx.doi.org/10.3390/ph16040631 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sarhan, Rania M.
E. Altyar, Ahmed
Essam Abou Warda, Ahmed
Saied, Yasmine Mohamed
Ibrahim, Haytham Soliman Ghareeb
Schaalan, Mona F.
Fathy, Shaimaa
Sarhan, Neven
Boshra, Marian S.
Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial
title Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial
title_full Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial
title_fullStr Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial
title_full_unstemmed Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial
title_short Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial
title_sort pentoxifylline effects on hospitalized covid-19 patients with cytokine storm syndrome: a randomized clinical trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10142327/
https://www.ncbi.nlm.nih.gov/pubmed/37111389
http://dx.doi.org/10.3390/ph16040631
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