Influence of sulodexide at endothelial and blood cell condition in COVID-19 patients


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Abstract

In spite of the fact that the most expressed manifestation of COVID-19 is severe pulmonary damage, it is shown by clinical observations that other organs are often affected too in that infection. This multi-organ pathology is caused by disorders in haemostasis and endothelial function. Since there are no medicaments that can directly inhibit the activity of SARS-CoV-2, the effort to mitigate its damaging effects by protecting the endothelium and preventing hemostasis disruption looks to be essential. We investigated the ability of sulodexide, which is a mixture of a fast heparin fraction (80%) and dermatan sulfate (20%), to have a therapeutic effect in COVID 19. Material and methods. 28 patients with moderate COVID-19 were engaged in a single-center, prospective, observational study. Patients in the control group (n=14) were treated using the therapy according to the Ministry of Healthcare recommendations, and patients in the experimental group (n=14) received daily intravenous injections of sulodexide (600 units) in addition to this therapy for ten days. Blood samples were obtained from the ulnar vein on admission and 10 days later and were examined by scanning electron microscopy. Results. Sulodexide significantly reduced the concentration of circulating endothelial cells. That indicated its ability to protect the endothelium from the damaging effects of the virus. It also prevented additional platelet activation and erythrocyte aggregation, which inhibited the normal passage of these cells through the capillaries. Conclusion. The results showed that sulodexide is able to prevent thrombosis and suppress vascular inflammation. This makes it to be a promising treatment remedy for COVID-19 patients, although a randomised trial on a large number of patients is needed to validate this conclusion.

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About the authors

Lyudmila I. Buryachkovskaya

Academician E.I. Chazov National Medical Research Center of Cardiology of the Ministry of Healthcare of Russia

Email: livbur@mail.ru
D.Sc.(Biology), leading researcher 121552 Moscow, 15a, 3rd Cherepkovskaya Str

Arthur M. Melkumyants

Academician E.I. Chazov National Medical Research Center of Cardiology of the Ministry of Healthcare of Russia; Moscow Institute of Physics and Technology (National Research University)

Email: artmelk@gmail.com
D.Sc.(Biology), professor, leading researcher 121552 Moscow, 15a, 3rd Cherepkovskaya Str

Nikita V. Lomakin

Central Clinical Hospital with Polyclinic of the Administrative Department of the President of the Russian Federation; Russian Medical Academy of Continuing Professional Education of the Ministry of Healthcare of Russia

Email: lomakinnikita@gmail.com
Dr. med. habil., chief external expert cardiologist of Russian Presidential Administration, head of the Department of emergency cardiology and cardiac resuscitation; head of the Department of cardiology 125993, Moscow, 2/1 bld.1 Barrikadnaya Str

Olga A. Antonova

Academician E.I. Chazov National Medical Research Center of Cardiology of the Ministry of Healthcare of Russia

researcher at Academician 121552 Moscow, 15a, 3rd Cherepkovskaya Str

Vladimir V. Ermishkin

Academician E.I. Chazov National Medical Research Center of Cardiology of the Ministry of Healthcare of Russia

PhD in Medicine, leading researcher 121552 Moscow, 15a, 3rd Cherepkovskaya Str

Yulia V. Dotsenko

Academician E.I. Chazov National Medical Research Center of Cardiology of the Ministry of Healthcare of Russia

PhD., researcher 121552 Moscow, 15a, 3rd Cherepkovskaya Str

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