Inhalation surfactant therapy in the integrated treatment of severe COVID-19 pneumonia

The objective: to evaluate the effectiveness of inhaled surfactant therapy in the integrated treatment of severe COVID-19 pneumonia in a multicenter prospective clinical trial of surfactant-BL.Subjects and methods. 122 patients with severe COVID-19-associated pneumonia treated in two treatment cente...

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Main Authors: A. E. Bautin, S. N. Avdeev, A. A. Seyliev, M. V. Shvechkova, Z. M. Merzhoeva, N. V. Trushenko, A. P. Semenov, K. B. Lapshin, O. A. Rozenberg
Format: Article
Language:Russian
Published: New Terra Publishing House 2020-10-01
Series:Туберкулез и болезни лёгких
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Online Access:https://www.tibl-journal.com/jour/article/view/1456
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author A. E. Bautin
S. N. Avdeev
A. A. Seyliev
M. V. Shvechkova
Z. M. Merzhoeva
N. V. Trushenko
A. P. Semenov
K. B. Lapshin
O. A. Rozenberg
author_facet A. E. Bautin
S. N. Avdeev
A. A. Seyliev
M. V. Shvechkova
Z. M. Merzhoeva
N. V. Trushenko
A. P. Semenov
K. B. Lapshin
O. A. Rozenberg
author_sort A. E. Bautin
collection DOAJ
description The objective: to evaluate the effectiveness of inhaled surfactant therapy in the integrated treatment of severe COVID-19 pneumonia in a multicenter prospective clinical trial of surfactant-BL.Subjects and methods. 122 patients with severe COVID-19-associated pneumonia treated in two treatment centers were enrolled in the study. All of them received antiviral, anticoagulant and anti-inflammatory therapy. 56 patients also received inhalation therapy with surfactant-BL (OOO Biosurf, St. Petersburg, Russia) at a dose of 1 mg/kg 2-3 times a day. The remaining 66 patients received no surfactant-BL inhalation. When included into the study, all patients were divided into two groups based on severity of the condition at the time of inclusion: 62 people (Group I) needed oxygen inhalation through a face mask with the flow of 6-8 L/min for hypoxemia correction (27 received surfactant therapy and 35 did not); other 60 patients (Group II) required non-invasive respiratory support (constant positive airway pressure, non-invasive mechanical ventilation, high-flow oxygen therapy), of them 29 received surfactant therapy, while 31 patients did not.Results. In Group I, switching to invasive mechanical ventilation was required for 3/27 (11.1%) patients who received surfactant therapy, and 10/35 (28.6%) who received no surfactant therapy (p = 0.085); lethality made 3/27 (11.1%) and 9/35 (25.7%) (p = 0.131), respectively. In Group II, among those who received surfactant therapy, 5/29 (17.2%) were switched to invasive mechanical ventilation and 18/31 (58.1%) among those who did not receive it (p = 0.001); lethality made 5/29 (17.2%) and 18/31 (58.1%) (p = 0.001), respectively. In the pooled group of 122 patients with severe COVID-19-associated pneumonia, 8 (14.3%) of 56 patients who received surfactant died, and 27 (40.9%) of 66 died among those who did not receive it, (p = 0.001).Conclusion: Inhalation surfactant therapy can reduce the frequency of switching patients to mechanical ventilation and statistically significantly reduce lethality caused by severe pneumonia associated with SARS-CoV-2.
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series Туберкулез и болезни лёгких
spelling doaj-art-bfa89b9d93084877b4cc48253743bea32025-08-20T02:05:48ZrusNew Terra Publishing HouseТуберкулез и болезни лёгких2075-12302542-15062020-10-0198961210.21292/2075-1230-2020-98-9-6-121454Inhalation surfactant therapy in the integrated treatment of severe COVID-19 pneumoniaA. E. Bautin0S. N. Avdeev1A. A. Seyliev2M. V. Shvechkova3Z. M. Merzhoeva4N. V. Trushenko5A. P. Semenov6K. B. Lapshin7O. A. Rozenberg8Almazov National Medical Research CenterI.M. Sechenov First Moscow State Medical University (Sechenov University)A.M. Granov Russian Research Center of Radiology and Surgical TechnologiesPerinatal CenterI.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)Almazov National Medical Research CenterAlmazov National Medical Research CenterA.M. Granov Russian Research Center of Radiology and Surgical TechnologiesThe objective: to evaluate the effectiveness of inhaled surfactant therapy in the integrated treatment of severe COVID-19 pneumonia in a multicenter prospective clinical trial of surfactant-BL.Subjects and methods. 122 patients with severe COVID-19-associated pneumonia treated in two treatment centers were enrolled in the study. All of them received antiviral, anticoagulant and anti-inflammatory therapy. 56 patients also received inhalation therapy with surfactant-BL (OOO Biosurf, St. Petersburg, Russia) at a dose of 1 mg/kg 2-3 times a day. The remaining 66 patients received no surfactant-BL inhalation. When included into the study, all patients were divided into two groups based on severity of the condition at the time of inclusion: 62 people (Group I) needed oxygen inhalation through a face mask with the flow of 6-8 L/min for hypoxemia correction (27 received surfactant therapy and 35 did not); other 60 patients (Group II) required non-invasive respiratory support (constant positive airway pressure, non-invasive mechanical ventilation, high-flow oxygen therapy), of them 29 received surfactant therapy, while 31 patients did not.Results. In Group I, switching to invasive mechanical ventilation was required for 3/27 (11.1%) patients who received surfactant therapy, and 10/35 (28.6%) who received no surfactant therapy (p = 0.085); lethality made 3/27 (11.1%) and 9/35 (25.7%) (p = 0.131), respectively. In Group II, among those who received surfactant therapy, 5/29 (17.2%) were switched to invasive mechanical ventilation and 18/31 (58.1%) among those who did not receive it (p = 0.001); lethality made 5/29 (17.2%) and 18/31 (58.1%) (p = 0.001), respectively. In the pooled group of 122 patients with severe COVID-19-associated pneumonia, 8 (14.3%) of 56 patients who received surfactant died, and 27 (40.9%) of 66 died among those who did not receive it, (p = 0.001).Conclusion: Inhalation surfactant therapy can reduce the frequency of switching patients to mechanical ventilation and statistically significantly reduce lethality caused by severe pneumonia associated with SARS-CoV-2.https://www.tibl-journal.com/jour/article/view/1456covid-19influenza a/h1n1viral pneumoniaardsacute respiratory failure
spellingShingle A. E. Bautin
S. N. Avdeev
A. A. Seyliev
M. V. Shvechkova
Z. M. Merzhoeva
N. V. Trushenko
A. P. Semenov
K. B. Lapshin
O. A. Rozenberg
Inhalation surfactant therapy in the integrated treatment of severe COVID-19 pneumonia
Туберкулез и болезни лёгких
covid-19
influenza a/h1n1
viral pneumonia
ards
acute respiratory failure
title Inhalation surfactant therapy in the integrated treatment of severe COVID-19 pneumonia
title_full Inhalation surfactant therapy in the integrated treatment of severe COVID-19 pneumonia
title_fullStr Inhalation surfactant therapy in the integrated treatment of severe COVID-19 pneumonia
title_full_unstemmed Inhalation surfactant therapy in the integrated treatment of severe COVID-19 pneumonia
title_short Inhalation surfactant therapy in the integrated treatment of severe COVID-19 pneumonia
title_sort inhalation surfactant therapy in the integrated treatment of severe covid 19 pneumonia
topic covid-19
influenza a/h1n1
viral pneumonia
ards
acute respiratory failure
url https://www.tibl-journal.com/jour/article/view/1456
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