Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19

van Haren, Frank M.P.|||0000-0001-8037-4229; Neto, Ary Serpa; Schultz, Marcus J.|||0000-0003-3969-7792; Laffey, John|||0000-0002-1246-9573; Artigas Raventós, Antoni|||0000-0002-8029-1017; Dixon, Barry; Vilaseca, Alicia B; Barbera, Ruben A; Ismail, Tarek I; Mahrous, Rabab S; Badr, Mohamed; DeNucci, Gilberto; Sverdloff, Carlos; Camprubí-Rimblas, Marta|||0000-0002-4085-5324; Cosgrave, David W; McNicholas, Bairbre; Cody, Catriona; Curley, Gerard|||0000-0003-0271-195X; Smoot, Thomas L.|||0000-0002-6188-2217; Staas, Sabrina; Sann, Khine; Sas, Caitlin; Belani, Anusha; Hillman, Christopher; Manggala, Sidharta K.; Dita Aditianingsih; Sugiarto, Adhrie; Yulianti, Mira; Herikurniawan, Herikurniawan; Sinto, Robert; Auerkari, Aino N.; Permana, Septian Adi; Woodcock, Ashley; Carroll, Mary; Wilkinson, Tom; Singh, Dave|||0000-0001-8918-7075; Shute, Janis; Carroll, Miles; Page, Clive

Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19

Inhaled nebulised unfractionated heparin (UFH) has a strong rationale as a treatment for severe respiratory infections, including COVID-19, due to its antiviral, anti-inflammatory, and anti-coagulant properties, which may prevent viral entry, lung injury progression, and pulmonary thrombosis. We aim...

Descripción completa

Detalles Bibliográficos
Autores:	van Haren, Frank M.P.\|\|\|0000-0001-8037-4229, Neto, Ary Serpa, Schultz, Marcus J.\|\|\|0000-0003-3969-7792, Laffey, John\|\|\|0000-0002-1246-9573, Artigas Raventós, Antoni\|\|\|0000-0002-8029-1017, Dixon, Barry, Vilaseca, Alicia B, Barbera, Ruben A, Ismail, Tarek I, Mahrous, Rabab S, Badr, Mohamed, DeNucci, Gilberto, Sverdloff, Carlos, Camprubí-Rimblas, Marta\|\|\|0000-0002-4085-5324, Cosgrave, David W, McNicholas, Bairbre, Cody, Catriona, Curley, Gerard\|\|\|0000-0003-0271-195X, Smoot, Thomas L.\|\|\|0000-0002-6188-2217, Staas, Sabrina, Sann, Khine, Sas, Caitlin, Belani, Anusha, Hillman, Christopher, Manggala, Sidharta K., Dita Aditianingsih, Sugiarto, Adhrie, Yulianti, Mira, Herikurniawan, Herikurniawan, Sinto, Robert, Auerkari, Aino N., Permana, Septian Adi, Woodcock, Ashley, Carroll, Mary, Wilkinson, Tom, Singh, Dave\|\|\|0000-0001-8918-7075, Shute, Janis, Carroll, Miles, Page, Clive
Tipo de recurso:	artículo
Fecha de publicación:	2025
País:	España
Institución:	Universitat Autònoma de Barcelona
Repositorio:	Dipòsit Digital de Documents de la UAB
Idioma:	inglés
OAI Identifier:	oai:dnet:uabarcelona_::7f962f1ca4fca807465c1418db0529e6
Acceso en línea:	https://ddd.uab.cat/record/327140 https://dx.doi.org/urn:doi:10.1016/j.eclinm.2025.103339
Access Level:	acceso abierto
Palabra clave:	COVID-19 ARDS Inhaled heparin Nebulised heparin Unfractionated heparin SARS-CoV-2 Respiratory failure Pandemic Randomised trial Meta-trial Intubation Mortality

id	ES_0bb697f46e4fd4988bf39f11e1e63bef
oai_identifier_str	oai:dnet:uabarcelona_::7f962f1ca4fca807465c1418db0529e6
network_acronym_str	ES
network_name_str	España
repository_id_str
spelling	Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19an investigator-initiated international meta-trial of randomised clinical studiesvan Haren, Frank M.P.\|\|\|0000-0001-8037-4229Neto, Ary SerpaSchultz, Marcus J.\|\|\|0000-0003-3969-7792Laffey, John\|\|\|0000-0002-1246-9573Artigas Raventós, Antoni\|\|\|0000-0002-8029-1017Dixon, BarryVilaseca, Alicia BBarbera, Ruben AIsmail, Tarek IMahrous, Rabab SBadr, MohamedDeNucci, GilbertoSverdloff, CarlosCamprubí-Rimblas, Marta\|\|\|0000-0002-4085-5324Cosgrave, David WMcNicholas, BairbreCody, CatrionaCurley, Gerard\|\|\|0000-0003-0271-195XSmoot, Thomas L.\|\|\|0000-0002-6188-2217Staas, SabrinaSann, KhineSas, CaitlinBelani, AnushaHillman, ChristopherManggala, Sidharta K.Dita AditianingsihSugiarto, AdhrieYulianti, MiraHerikurniawan, HerikurniawanSinto, RobertAuerkari, Aino N.Permana, Septian AdiWoodcock, AshleyCarroll, MaryWilkinson, TomSingh, Dave\|\|\|0000-0001-8918-7075Shute, JanisCarroll, MilesPage, CliveCOVID-19ARDSInhaled heparinNebulised heparinUnfractionated heparinSARS-CoV-2Respiratory failurePandemicRandomised trialMeta-trialIntubationMortalityInhaled nebulised unfractionated heparin (UFH) has a strong rationale as a treatment for severe respiratory infections, including COVID-19, due to its antiviral, anti-inflammatory, and anti-coagulant properties, which may prevent viral entry, lung injury progression, and pulmonary thrombosis. We aimed to evaluate the efficacy of inhaled nebulised UFH to prevent intubation or death in hospitalised COVID-19 patients. In this prospective, a priori set up and defined, collaborative meta-trial of six randomised clinical studies, adult hospitalised but not intubated COVID-19 patients were randomly assigned to inhaled nebulised UFH on top of standard of care or standard of care alone. The dose and method of nebulisation was specific to each study. The primary outcome was intubation or death, assessed at the longest follow-up after randomisation. The meta-trial was registered at ID . Between June 2020 and December 2022, 478 patients from 10 hospitals in six countries (Argentina, Brazil, Egypt, Indonesia, Ireland and USA) were enrolled. The odds ratio (OR) for intubation or death was 0.43 (0.26-0.73, p = 0.001); the OR for in-hospital mortality was 0.26 (0.13-0.54, p. <0.001) with inhaled nebulised UFH compared to standard of care alone. There were no safety issues reported, including no instances of pulmonary or systemic bleeding in the nebulised UFH group. Interpretation: In patients hospitalised but not intubated for COVID-19, inhaled nebulised UFH prevented intubation and reduced mortality, without causing pulmonary or systemic bleeding. 22025-01-0120252025-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/327140https://dx.doi.org/urn:doi:10.1016/j.eclinm.2025.103339reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:dnet:uabarcelona_::7f962f1ca4fca807465c1418db0529e62026-06-06T12:50:31Z
dc.title.none.fl_str_mv	Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19 an investigator-initiated international meta-trial of randomised clinical studies
title	Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19
spellingShingle	Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19 van Haren, Frank M.P.\|\|\|0000-0001-8037-4229 COVID-19 ARDS Inhaled heparin Nebulised heparin Unfractionated heparin SARS-CoV-2 Respiratory failure Pandemic Randomised trial Meta-trial Intubation Mortality
title_short	Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19
title_full	Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19
title_fullStr	Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19
title_full_unstemmed	Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19
title_sort	Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19
dc.creator.none.fl_str_mv	van Haren, Frank M.P.\|\|\|0000-0001-8037-4229 Neto, Ary Serpa Schultz, Marcus J.\|\|\|0000-0003-3969-7792 Laffey, John\|\|\|0000-0002-1246-9573 Artigas Raventós, Antoni\|\|\|0000-0002-8029-1017 Dixon, Barry Vilaseca, Alicia B Barbera, Ruben A Ismail, Tarek I Mahrous, Rabab S Badr, Mohamed DeNucci, Gilberto Sverdloff, Carlos Camprubí-Rimblas, Marta\|\|\|0000-0002-4085-5324 Cosgrave, David W McNicholas, Bairbre Cody, Catriona Curley, Gerard\|\|\|0000-0003-0271-195X Smoot, Thomas L.\|\|\|0000-0002-6188-2217 Staas, Sabrina Sann, Khine Sas, Caitlin Belani, Anusha Hillman, Christopher Manggala, Sidharta K. Dita Aditianingsih Sugiarto, Adhrie Yulianti, Mira Herikurniawan, Herikurniawan Sinto, Robert Auerkari, Aino N. Permana, Septian Adi Woodcock, Ashley Carroll, Mary Wilkinson, Tom Singh, Dave\|\|\|0000-0001-8918-7075 Shute, Janis Carroll, Miles Page, Clive
author	van Haren, Frank M.P.\|\|\|0000-0001-8037-4229
author_facet	van Haren, Frank M.P.\|\|\|0000-0001-8037-4229 Neto, Ary Serpa Schultz, Marcus J.\|\|\|0000-0003-3969-7792 Laffey, John\|\|\|0000-0002-1246-9573 Artigas Raventós, Antoni\|\|\|0000-0002-8029-1017 Dixon, Barry Vilaseca, Alicia B Barbera, Ruben A Ismail, Tarek I Mahrous, Rabab S Badr, Mohamed DeNucci, Gilberto Sverdloff, Carlos Camprubí-Rimblas, Marta\|\|\|0000-0002-4085-5324 Cosgrave, David W McNicholas, Bairbre Cody, Catriona Curley, Gerard\|\|\|0000-0003-0271-195X Smoot, Thomas L.\|\|\|0000-0002-6188-2217 Staas, Sabrina Sann, Khine Sas, Caitlin Belani, Anusha Hillman, Christopher Manggala, Sidharta K. Dita Aditianingsih Sugiarto, Adhrie Yulianti, Mira Herikurniawan, Herikurniawan Sinto, Robert Auerkari, Aino N. Permana, Septian Adi Woodcock, Ashley Carroll, Mary Wilkinson, Tom Singh, Dave\|\|\|0000-0001-8918-7075 Shute, Janis Carroll, Miles Page, Clive
author_role	author
author2	Neto, Ary Serpa Schultz, Marcus J.\|\|\|0000-0003-3969-7792 Laffey, John\|\|\|0000-0002-1246-9573 Artigas Raventós, Antoni\|\|\|0000-0002-8029-1017 Dixon, Barry Vilaseca, Alicia B Barbera, Ruben A Ismail, Tarek I Mahrous, Rabab S Badr, Mohamed DeNucci, Gilberto Sverdloff, Carlos Camprubí-Rimblas, Marta\|\|\|0000-0002-4085-5324 Cosgrave, David W McNicholas, Bairbre Cody, Catriona Curley, Gerard\|\|\|0000-0003-0271-195X Smoot, Thomas L.\|\|\|0000-0002-6188-2217 Staas, Sabrina Sann, Khine Sas, Caitlin Belani, Anusha Hillman, Christopher Manggala, Sidharta K. Dita Aditianingsih Sugiarto, Adhrie Yulianti, Mira Herikurniawan, Herikurniawan Sinto, Robert Auerkari, Aino N. Permana, Septian Adi Woodcock, Ashley Carroll, Mary Wilkinson, Tom Singh, Dave\|\|\|0000-0001-8918-7075 Shute, Janis Carroll, Miles Page, Clive
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 author author author author author author author author author author author author author
dc.subject.none.fl_str_mv	COVID-19 ARDS Inhaled heparin Nebulised heparin Unfractionated heparin SARS-CoV-2 Respiratory failure Pandemic Randomised trial Meta-trial Intubation Mortality
topic	COVID-19 ARDS Inhaled heparin Nebulised heparin Unfractionated heparin SARS-CoV-2 Respiratory failure Pandemic Randomised trial Meta-trial Intubation Mortality
description	Inhaled nebulised unfractionated heparin (UFH) has a strong rationale as a treatment for severe respiratory infections, including COVID-19, due to its antiviral, anti-inflammatory, and anti-coagulant properties, which may prevent viral entry, lung injury progression, and pulmonary thrombosis. We aimed to evaluate the efficacy of inhaled nebulised UFH to prevent intubation or death in hospitalised COVID-19 patients. In this prospective, a priori set up and defined, collaborative meta-trial of six randomised clinical studies, adult hospitalised but not intubated COVID-19 patients were randomly assigned to inhaled nebulised UFH on top of standard of care or standard of care alone. The dose and method of nebulisation was specific to each study. The primary outcome was intubation or death, assessed at the longest follow-up after randomisation. The meta-trial was registered at ID . Between June 2020 and December 2022, 478 patients from 10 hospitals in six countries (Argentina, Brazil, Egypt, Indonesia, Ireland and USA) were enrolled. The odds ratio (OR) for intubation or death was 0.43 (0.26-0.73, p = 0.001); the OR for in-hospital mortality was 0.26 (0.13-0.54, p. <0.001) with inhaled nebulised UFH compared to standard of care alone. There were no safety issues reported, including no instances of pulmonary or systemic bleeding in the nebulised UFH group. Interpretation: In patients hospitalised but not intubated for COVID-19, inhaled nebulised UFH prevented intubation and reduced mortality, without causing pulmonary or systemic bleeding.
publishDate	2025
dc.date.none.fl_str_mv	2 2025-01-01 2025 2025-01-01
dc.type.none.fl_str_mv	Article http://purl.org/coar/resource_type/c_6501 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv	info:eu-repo/semantics/article
format	article
dc.identifier.none.fl_str_mv	https://ddd.uab.cat/record/327140 https://dx.doi.org/urn:doi:10.1016/j.eclinm.2025.103339
url	https://ddd.uab.cat/record/327140 https://dx.doi.org/urn:doi:10.1016/j.eclinm.2025.103339
dc.language.none.fl_str_mv	Inglés eng
language_invalid_str_mv	Inglés
language	eng
dc.rights.none.fl_str_mv	open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv	info:eu-repo/semantics/openAccess
rights_invalid_str_mv	open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv	openAccess
dc.format.none.fl_str_mv	application/pdf
dc.source.none.fl_str_mv	reponame:Dipòsit Digital de Documents de la UAB instname:Universitat Autònoma de Barcelona
instname_str	Universitat Autònoma de Barcelona
reponame_str	Dipòsit Digital de Documents de la UAB
collection	Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_	1869403243217420288
score	15,812429

Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19

Similares en LA Referencia