Efficacy of Sildenafil in Patients with Severe COVID-19 and Pulmonary Arterial Hypertension.
Viruses
; 15(5)2023 05 11.
Artigo
em Inglês
| MEDLINE | ID: covidwho-20240790
ABSTRACT
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.
Palavras-chave
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
MEDLINE
Assunto principal:
Hipertensão Arterial Pulmonar
/
COVID-19
/
Hipertensão Pulmonar
Tipo de estudo:
Estudo experimental
/
Estudo prognóstico
/
Ensaios controlados aleatorizados
Limite:
Humanos
Idioma:
Inglês
Ano de publicação:
2023
Tipo de documento:
Artigo
País de afiliação:
V15051157
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