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Efficacy of Sildenafil in Patients with Severe COVID-19 and Pulmonary Arterial Hypertension

Pulmonary arterial hypertension (PAH) is common in severe coronavirus disease 2019 (COVID-19) and worsens the prognosis. Sildenafil, a phosphodiesterase-5 inhibitor, is approved for PAH treatment but little is known about its efficacy in cases of severe COVID-19 with PAH. This study aimed to investi...

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Autores principales: Oliynyk, Oleksandr Valentynovych, Rorat, Marta, Strepetova, Olena Vadymivna, Dubrov, Serhij Oleksandrovych, Guryanov, Vitaliy Grygorovych, Oliynyk, Yanina Volodymyrivna, Kulivets, Oleksii Serhijovych, Ślifirczyk, Anna, Barg, Wojciech
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10223625/
https://www.ncbi.nlm.nih.gov/pubmed/37243243
http://dx.doi.org/10.3390/v15051157
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author Oliynyk, Oleksandr Valentynovych
Rorat, Marta
Strepetova, Olena Vadymivna
Dubrov, Serhij Oleksandrovych
Guryanov, Vitaliy Grygorovych
Oliynyk, Yanina Volodymyrivna
Kulivets, Oleksii Serhijovych
Ślifirczyk, Anna
Barg, Wojciech
author_facet Oliynyk, Oleksandr Valentynovych
Rorat, Marta
Strepetova, Olena Vadymivna
Dubrov, Serhij Oleksandrovych
Guryanov, Vitaliy Grygorovych
Oliynyk, Yanina Volodymyrivna
Kulivets, Oleksii Serhijovych
Ślifirczyk, Anna
Barg, Wojciech
author_sort Oliynyk, Oleksandr Valentynovych
collection PubMed
description Pulmonary arterial hypertension (PAH) is common in severe coronavirus disease 2019 (COVID-19) and worsens the prognosis. Sildenafil, a phosphodiesterase-5 inhibitor, is approved for PAH treatment but little is known about its efficacy in cases of severe COVID-19 with PAH. This study aimed to investigate the clinical efficacy of sildenafil in patients with severe COVID-19 and PAH. Intensive care unit (ICU) patients were randomly assigned to receive sildenafil or a placebo, with 75 participants in each group. Sildenafil was administered orally at 0.25 mg/kg t.i.d. for one week in a placebo-controlled, double-blind manner as an add-on therapy alongside the patient’s routine treatment. The primary endpoint was one-week mortality, and the secondary endpoints were the one-week intubation rate and duration of ICU stay. The mortality rate was 4% vs. 13.3% (p = 0.078), the intubation rate was 8% and 18.7% (p = 0.09), and the length of ICU stay was 15 vs. 19 days (p < 0.001) for the sildenafil and placebo groups, respectively. If adjusted for PAH, sildenafil treatment significantly reduced mortality and intubation risks: OR = 0.21 (95% CI: 0.05–0.89) and OR = 0.26 (95% CI: 0.08–0.86), respectively. Sildenafil demonstrated some clinical efficacy in patients with severe COVID-19 and PAH and should be considered as an add-on therapy in these patients.
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spelling pubmed-102236252023-05-28 Efficacy of Sildenafil in Patients with Severe COVID-19 and Pulmonary Arterial Hypertension Oliynyk, Oleksandr Valentynovych Rorat, Marta Strepetova, Olena Vadymivna Dubrov, Serhij Oleksandrovych Guryanov, Vitaliy Grygorovych Oliynyk, Yanina Volodymyrivna Kulivets, Oleksii Serhijovych Ślifirczyk, Anna Barg, Wojciech Viruses Article Pulmonary arterial hypertension (PAH) is common in severe coronavirus disease 2019 (COVID-19) and worsens the prognosis. Sildenafil, a phosphodiesterase-5 inhibitor, is approved for PAH treatment but little is known about its efficacy in cases of severe COVID-19 with PAH. This study aimed to investigate the clinical efficacy of sildenafil in patients with severe COVID-19 and PAH. Intensive care unit (ICU) patients were randomly assigned to receive sildenafil or a placebo, with 75 participants in each group. Sildenafil was administered orally at 0.25 mg/kg t.i.d. for one week in a placebo-controlled, double-blind manner as an add-on therapy alongside the patient’s routine treatment. The primary endpoint was one-week mortality, and the secondary endpoints were the one-week intubation rate and duration of ICU stay. The mortality rate was 4% vs. 13.3% (p = 0.078), the intubation rate was 8% and 18.7% (p = 0.09), and the length of ICU stay was 15 vs. 19 days (p < 0.001) for the sildenafil and placebo groups, respectively. If adjusted for PAH, sildenafil treatment significantly reduced mortality and intubation risks: OR = 0.21 (95% CI: 0.05–0.89) and OR = 0.26 (95% CI: 0.08–0.86), respectively. Sildenafil demonstrated some clinical efficacy in patients with severe COVID-19 and PAH and should be considered as an add-on therapy in these patients. MDPI 2023-05-11 /pmc/articles/PMC10223625/ /pubmed/37243243 http://dx.doi.org/10.3390/v15051157 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
Oliynyk, Oleksandr Valentynovych
Rorat, Marta
Strepetova, Olena Vadymivna
Dubrov, Serhij Oleksandrovych
Guryanov, Vitaliy Grygorovych
Oliynyk, Yanina Volodymyrivna
Kulivets, Oleksii Serhijovych
Ślifirczyk, Anna
Barg, Wojciech
Efficacy of Sildenafil in Patients with Severe COVID-19 and Pulmonary Arterial Hypertension
title Efficacy of Sildenafil in Patients with Severe COVID-19 and Pulmonary Arterial Hypertension
title_full Efficacy of Sildenafil in Patients with Severe COVID-19 and Pulmonary Arterial Hypertension
title_fullStr Efficacy of Sildenafil in Patients with Severe COVID-19 and Pulmonary Arterial Hypertension
title_full_unstemmed Efficacy of Sildenafil in Patients with Severe COVID-19 and Pulmonary Arterial Hypertension
title_short Efficacy of Sildenafil in Patients with Severe COVID-19 and Pulmonary Arterial Hypertension
title_sort efficacy of sildenafil in patients with severe covid-19 and pulmonary arterial hypertension
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10223625/
https://www.ncbi.nlm.nih.gov/pubmed/37243243
http://dx.doi.org/10.3390/v15051157
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