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Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019
Severe Coronavirus disease 2019 (COVID-19) is characterized by acute respiratory distress syndrome (ARDS) which may lead to long-lasting pulmonary sequelae in the survivors. COVID-19 shares common molecular signatures with interstitial lung diseases (ILDs), including pro-angiogenic and tissue-remode...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8581035/ https://www.ncbi.nlm.nih.gov/pubmed/34778326 http://dx.doi.org/10.3389/fmed.2021.766486 |
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author | Bussolari, Cecilia Palumbo, Diego Fominsky, Evgeni Nardelli, Pasquale De Lorenzo, Rebecca Vitali, Giordano De Cobelli, Francesco Rovere-Querini, Patrizia Scandroglio, Anna Mara |
author_facet | Bussolari, Cecilia Palumbo, Diego Fominsky, Evgeni Nardelli, Pasquale De Lorenzo, Rebecca Vitali, Giordano De Cobelli, Francesco Rovere-Querini, Patrizia Scandroglio, Anna Mara |
author_sort | Bussolari, Cecilia |
collection | PubMed |
description | Severe Coronavirus disease 2019 (COVID-19) is characterized by acute respiratory distress syndrome (ARDS) which may lead to long-lasting pulmonary sequelae in the survivors. COVID-19 shares common molecular signatures with interstitial lung diseases (ILDs), including pro-angiogenic and tissue-remodeling mechanisms mediated by vascular endothelial growth factor receptor (VEGF-R), fibroblast growth factor receptor (FGF-R), and platelet-derived growth factor receptor (PDGF-R). Nintedanib mainly targets these factors and is approved for ILDs. Therefore, we administered nintedanib through compassionate use to three patients with COVID-19 pneumonia requiring extra-corporeal membrane-oxygenation (ECMO). Here, we describe our experience in an attempt to explore the role of nintedanib in lung recovery in COVID-19. Three obese patients aged between 42 and 52 years were started on nintedanib due to difficulty in obtaining lung function restoration and weaning from ECMO support following the removal of orotracheal intubation (OTI). Soon after the start of the treatment, systemic inflammation and respiratory function rapidly improved and ECMO support was withdrawn. Serial chest CT scans confirmed the progressive lung amelioration, also reflected by functional tests during follow-up. Nintedanib was well-tolerated by all the three patients at the dosage used for ILDs and continued for 2–3 months based on drug availability. Although caution in interpreting events is required; it is tempting to speculate that nintedanib may have contributed to modulate lung inflammation and remodeling and to sustain lung repair. Altogether, nintedanib appears as a promising agent in patients with severe COVID-19 and delayed respiratory function recovery, for whom molecularly targeted therapies are still lacking. Clinical trials are necessary to confirm our observations. |
format | Online Article Text |
id | pubmed-8581035 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-85810352021-11-12 Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019 Bussolari, Cecilia Palumbo, Diego Fominsky, Evgeni Nardelli, Pasquale De Lorenzo, Rebecca Vitali, Giordano De Cobelli, Francesco Rovere-Querini, Patrizia Scandroglio, Anna Mara Front Med (Lausanne) Medicine Severe Coronavirus disease 2019 (COVID-19) is characterized by acute respiratory distress syndrome (ARDS) which may lead to long-lasting pulmonary sequelae in the survivors. COVID-19 shares common molecular signatures with interstitial lung diseases (ILDs), including pro-angiogenic and tissue-remodeling mechanisms mediated by vascular endothelial growth factor receptor (VEGF-R), fibroblast growth factor receptor (FGF-R), and platelet-derived growth factor receptor (PDGF-R). Nintedanib mainly targets these factors and is approved for ILDs. Therefore, we administered nintedanib through compassionate use to three patients with COVID-19 pneumonia requiring extra-corporeal membrane-oxygenation (ECMO). Here, we describe our experience in an attempt to explore the role of nintedanib in lung recovery in COVID-19. Three obese patients aged between 42 and 52 years were started on nintedanib due to difficulty in obtaining lung function restoration and weaning from ECMO support following the removal of orotracheal intubation (OTI). Soon after the start of the treatment, systemic inflammation and respiratory function rapidly improved and ECMO support was withdrawn. Serial chest CT scans confirmed the progressive lung amelioration, also reflected by functional tests during follow-up. Nintedanib was well-tolerated by all the three patients at the dosage used for ILDs and continued for 2–3 months based on drug availability. Although caution in interpreting events is required; it is tempting to speculate that nintedanib may have contributed to modulate lung inflammation and remodeling and to sustain lung repair. Altogether, nintedanib appears as a promising agent in patients with severe COVID-19 and delayed respiratory function recovery, for whom molecularly targeted therapies are still lacking. Clinical trials are necessary to confirm our observations. Frontiers Media S.A. 2021-10-28 /pmc/articles/PMC8581035/ /pubmed/34778326 http://dx.doi.org/10.3389/fmed.2021.766486 Text en Copyright © 2021 Bussolari, Palumbo, Fominsky, Nardelli, De Lorenzo, Vitali, De Cobelli, Rovere-Querini and Scandroglio. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Bussolari, Cecilia Palumbo, Diego Fominsky, Evgeni Nardelli, Pasquale De Lorenzo, Rebecca Vitali, Giordano De Cobelli, Francesco Rovere-Querini, Patrizia Scandroglio, Anna Mara Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019 |
title | Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019 |
title_full | Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019 |
title_fullStr | Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019 |
title_full_unstemmed | Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019 |
title_short | Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019 |
title_sort | case report: nintedaninb may accelerate lung recovery in critical coronavirus disease 2019 |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8581035/ https://www.ncbi.nlm.nih.gov/pubmed/34778326 http://dx.doi.org/10.3389/fmed.2021.766486 |
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