Anticoagulant Treatment of COVID-19 as Early as Possible—Sulodexide and Perspectives

Schulman, Sam; Harenberg, Job

doi:10.1055/a-1477-3569

Cited by 7 publications

(7 citation statements)

References 24 publications

(21 reference statements)

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“…Недавняя медицинская гипотеза предполагает, что гистоны, секретируемые НГ при COVID-19 (поликатионы) могут усугублять течение вирусных инфекций, на которые можно воздействовать введением отрицательно заряженных полианионных препаратов (например, гепаринов и гепаринои дов) [51]. В частности, лечение COVID-19 гепаринами и гепариноидами продемонстрировало их благотворное влияние через сложные биомолекулярные механизмы, основанные как на неантикоагулянтных, так и на антикоагулянтных свойствах [39,69,88,119]. Согласно этому проводились различные исследования, в рамках которых наблюдали значительно отличающуюся in vitro модуляцию индуцированного гистонами воспаления и коа гуляции цельной крови несколькими синтетическими и природными гепаринами и гепариноидами на основе гликозаминогликанов, часто используемыми для лечения COVID-19 в соответствии с рекомендациями ВОЗ по состоянию на 5 февраля 2022 г., такие как нефракционированный гепарин, низкомолекулярные гепарины (НМГ), данапароид натрия, фондапаринукс и сулодексид [33,39,129].…”

Section: антигистоновая терапияunclassified

The role of neutrophil extracellular traps (NETs) in the immunopathogenesis of severe COVID-19: potential immunotherapeutic strategies regulating NET formation and activity

Нестерова

Atazhakhova

Teterin

et al. 2023

Russian Journal of Infection and Immunity

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The role of neutrophil granulocytes (NG) in the pathogenesis of COVID-19 is associated with the recruitment of NG into inflammatory foci, activation of their functions and enhanced formation of neutrophil extracellular networks (NETs). In this review, we analyzed a fairly large volume of scientific literature devoted to the peculiarities of the formation of NETs, their role in the pathogenesis of COVID-19, participation in the occurrence of immunothrombosis, vasculitis, acute respiratory distress syndrome, cytokine storm syndrome, multi-organ lesions. Convincing data are presented that clearly indicate the significant involvement of NETs in the immunopathogenesis of COVID-19 and the associated severe complications resulting from the intensification of the inflammation process, which is key for the course of infection caused by the SARS-CoV-2 virus. The presented role of NG and NETs, along with the role of other immune system cells and pro-inflammatory cytokines, is extremely important in understanding the development of an overactive immune response in severe COVID-19. The obtained scientific results, available today, allow identifying the possibilities of regulatory effects on hyperactivated NG, on the formation of NETs at various stages and on limiting the negative impact of already formed NETs on various tissues and organs. All of the above should help in the creation of new, specialized immunotherapy strategies designed to increase the chances of survival, reduce the severity of clinical manifestations in patients with COVID-19, as well as significantly reduce mortality rates. Currently, it is possible to use existing drugs and a number of new drugs are being developed, the action of which can regulate the amount of NG, positively affect the functions of NG and limit the intensity of NETs formation. Continuing research on the role of hyperactive NG and netosis, as well as understanding the mechanisms of regulation of the phenomenon of formation and restriction of NETs activity in severe COVID-19, apparently, are a priority, since in the future the new data obtained could become the basis for the development of targeted approaches not only to immunotherapy aimed at limiting education and blocking negative effects already formed NETs in severe COVID-19, but also to immunotherapy, which could be used in the complex treatment of other netopathies, first of all, autoimmune diseases, auto-inflammatory syndromes, severe purulent-inflammatory processes, including bacterial sepsis and hematogenous osteomyelitis.

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Section: антигистоновая терапияunclassified

The role of neutrophil extracellular traps (NETs) in the immunopathogenesis of severe COVID-19: potential immunotherapeutic strategies regulating NET formation and activity

Нестерова

Atazhakhova

Teterin

et al. 2023

Russian Journal of Infection and Immunity

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“…Can the occurrence of bleeding events be avoided without increasing the anticoagulant dose? There have been articles supporting early prophylactic anticoagulation ( Terpos et al, 2020 ; Rentsch et al, 2021 ; Arslan et al, 2021 ; Schulman and Harenberg 2021 ; Kollias et al, 2021 ). One study showed that early initiation of prophylactic anticoagulation was associated with a reduced risk of 30-day death without an increased risk of serious bleeding events ( Rentsch et al, 2021 ).…”

Section: Treatmentmentioning

confidence: 99%

Circulating Microparticles in the Pathogenesis and Early Anticoagulation of Thrombosis in COVID-19 With Kidney Injury

Wang

Novakovic

et al. 2022

Front. Cell Dev. Biol.

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As more is learned about the pathophysiological mechanisms of COVID-19, systemic thrombosis has been recognized as being associated with more severe clinical manifestations, mortality and sequelae. As many as 40% of patients admitted to the hospital due to COVID-19 have acute kidney injury, with coagulation abnormalities the main cause of impaired function. However, the mechanism of renal thrombosis and the process leading to kidney injury are unclear. Microparticles (MPs) are membrane bubbles released in response to activation, injury or apoptosis of cells. The phosphatidylserine (PS) exposed on the surface of MPs provides binding sites for endogenous and exogenous FXase complexes and prothrombin complexes, thus providing a platform for the coagulation cascade reaction and facilitating clot formation. In the context of COVID-19 infection, viral attack leads immune cells to release cytokines that damage circulating blood cells and vascular endothelial cells, resulting in increased MPs levels. Therefore, MPs can be used as a risk factor to predict renal microthrombosis and kidney injury. In this paper, we have summarized the latest data on the pathophysiological mechanism and treatment of renal thrombosis caused by MPs in COVID-19, revealing that the coagulation abnormality caused by MP and PS storms is a universal progression that aggravates the mortality and sequelae of COVID-19 and potentially other pandemic diseases. This paper also describes the risk factors affecting renal thrombosis in COVID-19 from the perspective of the Virchow’s triad: blood hypercoagulability, vascular endothelial injury, and decreased blood flow velocity. In summary, given the serious consequences of thrombosis, current guidelines and clinical studies suggest that early prophylactic anticoagulant therapy reduces mortality and improves clinical outcomes. Early anticoagulation, through inhibition of PS-mediated coagulopathy, allows maintenance of unobstructed blood circulation and oxygen delivery thereby facilitating the removal of inflammatory factors, viruses, MPs, and dead or damaged cells, and expediting patient rehabilitation.

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“…Early administration of antithrombotic agents such as low-molecular-weight heparin (LMWH), direct orally active factor Xa inhibitors (apixaban, rivaroxaban), or sulodexide to patients at risk of disease worsening reduces the risk of hospitalization, need for oxygen support, or even mortality. 112 113 114 115 116 117 Nevertheless, particularly for LMWHs, the optimal dose needs to be thoroughly evaluated. 118 The organization of the necessary framework for home-based medical care will be of major importance for the optimal administration of the forthcoming specific antiviral treatments which are currently under investigation or clinical development.…”

Section: Prevention Detection Anticipationmentioning

confidence: 99%

The COVID-19 Pandemic and the Need for an Integrated and Equitable Approach: An International Expert Consensus Paper

et al. 2021

Self Cite

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One year after the declaration of the COVID-19 pandemic by the World Health Organization (WHO) and despite the implementation of mandatory physical barriers and social distancing, humanity remains challenged by a long-lasting and devastating public health crisis. Non-pharmacological interventions (NPI) are efficient mitigation strategies. The success of these intense NPI is dependent on the approval and commitment of the population. The launch of a mass vaccination program in many countries in late December 2020 with mRNA vaccines, adenovirus-based vaccines, and inactivated virus vaccines has generated hope for the end of the pandemic. Current issues: The continuous appearance of new pathogenic viral strains and the ability of vaccines to prevent infection and transmission raise important concerns as we try to achieve community immunity against SARS-CoV-2 and its variants. The need of a second and even third generation of vaccines and the possibility of potentially harmful side-effects of the vaccines (i.e. venous thromboembolism ) have already been acknowledged. Perspectives: There is a critical and urgent need for a balanced and integrated strategy for the management of the COVID-19 outbreaks organized on three axes: (1) Prevention of the SARS-CoV-2 infection, (2) Detection and early diagnosis of patients at risk of disease worsening, and (3) Anticipation of medical care (PDA). Conclusion: The “PDA strategy” integrated into state policy for the support and expansion of health systems and introduction of digital organization (i.e. telemedicine, artificial intelligence and machine learning technology) is of major importance for the preservation of citizens’ health and life world-wide.

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Anticoagulant Treatment of COVID-19 as Early as Possible—Sulodexide and Perspectives

Abstract: No Abstract

Cited by 7 publications

References 24 publications

The role of neutrophil extracellular traps (NETs) in the immunopathogenesis of severe COVID-19: potential immunotherapeutic strategies regulating NET formation and activity

The role of neutrophil extracellular traps (NETs) in the immunopathogenesis of severe COVID-19: potential immunotherapeutic strategies regulating NET formation and activity

Circulating Microparticles in the Pathogenesis and Early Anticoagulation of Thrombosis in COVID-19 With Kidney Injury

The COVID-19 Pandemic and the Need for an Integrated and Equitable Approach: An International Expert Consensus Paper

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