Sulodexide Significantly Improves Endothelial Dysfunction and Alleviates Chest Pain and Palpitations in Patients With Long-COVID-19: Insights From TUN-EndCOV Study

Frontiers in Cardiovascular Medicine

article

Salma Charfeddine¹  Hassen Ibnhadjamor³  Jihen Jdidi²  Slim Torjmen²  Salma Kraiem³  Amine Bahloul¹  Ahmed Makni¹  Nesrine Kallel²  Nedia Moussa²  Mariem Boudaya²  Imen Touil⁷  Aiman Ghrab²  Jamel Elghoul²  Zeineb Meddeb^1,10  Yamina Thabet^1,10  Kais Ben Salem^1,11  Faouzi Addad^1,12  Kamel Bouslama^1,10  Sami Milouchi²  Rania Hammami¹  Salem Abdessalem^1,13  Leila Abid¹ 

[1] Cardiology Department, Hedi Chaker University Hospital;Faculty of Medicine, University of Sfax;Cardiology Department, Tahar Sfar Hospital;Preventive Medicine Department, Hedi Chaker University Hospital;Pneumology Department, Hedi Chaker University Hospital;Biochemistry Laboratory, Hedi Chaker University Hospital;Pneumology Department, Tahar Sfar Hospital;Cardiology Department, Habib Bourguiba Hospital Medenine;Pneumology Department, Habib Bourguiba Hospital Medenine;Internal Medicine Department, Mongi Slim LaMarsa Hospital;Private Doctor;Clinic Hannibal Tunis;Clinic Pasteur Tunis

关键词: COVID-19;    sulodexide;    long COVID-19 syndrome;    endothelial dysfunction;    microcirculation;   

DOI  :  10.3389/fcvm.2022.866113

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Objective Non-respiratory long-coronavirus disease 2019 (COVID-19) symptoms are mainly related to a long-lasting endothelial dysfunction and microcirculation impairment. We hypothesized that Sulodexide, a purified glycosaminoglycan mixture with a beneficial endothelial effect in arterial and venous peripheral diseases, may be effective in a subset of patients with long COVID-19. Approach and Results We conducted a multicenter prospective quasi-experimental study. A total of 290 patients from the TUN-EndCOV study with long-COVID-19 symptoms and endothelial dysfunction were included. The endothelial function was clinically assessed using a post-occlusive reactive hyperemia protocol with finger thermal monitoring device. Endothelial quality index (EQI) was assessed at inclusion and at 21 days later. The study population was assigned to a sulodexide group (144 patients) or a no-medical treatment group (146 patients). Clinical characteristics were similar at inclusion in the two groups. Fatigue, shortness of breath, and chest pain were the most common symptoms, respectively, 54.5, 53.8, and 28.3%. At 21 days, the sulodexide group improved significantly better than the no-medical treatment group in chest pain (83.7 vs. 43.6%, p < 10 −3 ), palpitations (85.2 vs. 52.9%, p = 0.009), and endothelial function [median delta-EQI 0.66 (0.6) vs. 0.18 (0.3); p < 10 −3 ]. Endothelial function improvement was significantly correlated with chest pain and palpitations recovery (AUC, i.e., area under the curve = 0.66, CI [0.57– 0.75], p = 0.001 and AUC = 0.60, CI [0.51– 0.69], p = 0.03, respectively). Conclusion Sulodexide significantly improves long-lasting post-COVID-19 endothelial dysfunction and alleviates chest pain and palpitations.

【 授权许可】

CC BY