Treatment with Sulodexide Downregulates Biomarkers for Endothelial Dysfunction in Convalescent COVID-19 Patients
Introduction Persistent elevation of biomarkers associated with endothelial dysfunction in convalescent COVID-19 patients has been linked to an increased risk of long-term cardiovascular complications, including long COVID syndrome. Sulodexide, known for its vascular endothelial affinity, has demons...
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SAGE Publishing
2025-01-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/10760296241297647 |
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| author | Alejandro J Gonzalez-Ochoa MD Gyozo Szolnoky MD Ana G Hernandez-Ibarra MD Jawed Fareed PhD |
| author_facet | Alejandro J Gonzalez-Ochoa MD Gyozo Szolnoky MD Ana G Hernandez-Ibarra MD Jawed Fareed PhD |
| author_sort | Alejandro J Gonzalez-Ochoa MD |
| collection | DOAJ |
| description | Introduction Persistent elevation of biomarkers associated with endothelial dysfunction in convalescent COVID-19 patients has been linked to an increased risk of long-term cardiovascular complications, including long COVID syndrome. Sulodexide, known for its vascular endothelial affinity, has demonstrated pleiotropic protective properties. This study aims to evaluate the impact of sulodexide on serum levels of endothelial dysfunction biomarkers in patients during the convalescent phase of COVID-19. Methods We conducted a double-blind, single-center, randomized, placebo-controlled trial in Mexico, comparing sulodexide (250 LRU orally, twice daily) with placebo over 8 weeks in adult patients during early COVID-19 convalescence. Differences in serum biomarkers between the groups were analyzed using repeated measures and post hoc tests, with Thrombomodulin (TM) as the primary endpoint. Results Among 206 analyzed patients (103 in each group), at week 8, the sulodexide group exhibited significantly lower mean levels of Thrombomodulin (TM) (25.2 ± 7.9 ng/mL vs 29.9 ± 14.7 ng/mL, P = .03), von Willebrand Factor (vWF) (232 ± 131 U/dL vs 266 ± 122 U/dL, P = .02) and Interleukin-6 (IL-6) (12.5 ± 13.2 pg/mL vs 16.2 ± 16.5 pg/mL, P = .03) compared to the placebo group. D-dimer and C reactive protein (CRP) in the sulodexide group were also lowered. No significant differences were observed for P-selectin, fibrinogen, VCAM-1, or ICAM-1 levels. Conclusions Patients in the convalescent phase of COVID-19 who received sulodexide for eight weeks showed a reduction in TM, vWF, D-dimer, CRP, and IL-6 serum levels compared to placebo. These findings suggest a potential protective effect of sulodexide against thromboinflammation and endothelial damage. |
| format | Article |
| id | doaj-art-ce511193a3644477a40c03fbf659642d |
| institution | DOAJ |
| issn | 1938-2723 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SAGE Publishing |
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| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj-art-ce511193a3644477a40c03fbf659642d2025-08-20T02:54:26ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232025-01-013110.1177/10760296241297647Treatment with Sulodexide Downregulates Biomarkers for Endothelial Dysfunction in Convalescent COVID-19 PatientsAlejandro J Gonzalez-Ochoa MD0Gyozo Szolnoky MD1Ana G Hernandez-Ibarra MD2Jawed Fareed PhD3 Vascular and Endovascular Surgery department, CLINEDEM, San Luis Rio Colorado, Sonora, México Department of Dermatology and Allergology, , Szeged, Hungary Otorhinolaryngology department, CLINEDEM, San Luis Rio Colorado, Sonora, México Hemostasis and Thrombosis Research Laboratories, Loyola University Medical Center, Maywood, Illinois, USAIntroduction Persistent elevation of biomarkers associated with endothelial dysfunction in convalescent COVID-19 patients has been linked to an increased risk of long-term cardiovascular complications, including long COVID syndrome. Sulodexide, known for its vascular endothelial affinity, has demonstrated pleiotropic protective properties. This study aims to evaluate the impact of sulodexide on serum levels of endothelial dysfunction biomarkers in patients during the convalescent phase of COVID-19. Methods We conducted a double-blind, single-center, randomized, placebo-controlled trial in Mexico, comparing sulodexide (250 LRU orally, twice daily) with placebo over 8 weeks in adult patients during early COVID-19 convalescence. Differences in serum biomarkers between the groups were analyzed using repeated measures and post hoc tests, with Thrombomodulin (TM) as the primary endpoint. Results Among 206 analyzed patients (103 in each group), at week 8, the sulodexide group exhibited significantly lower mean levels of Thrombomodulin (TM) (25.2 ± 7.9 ng/mL vs 29.9 ± 14.7 ng/mL, P = .03), von Willebrand Factor (vWF) (232 ± 131 U/dL vs 266 ± 122 U/dL, P = .02) and Interleukin-6 (IL-6) (12.5 ± 13.2 pg/mL vs 16.2 ± 16.5 pg/mL, P = .03) compared to the placebo group. D-dimer and C reactive protein (CRP) in the sulodexide group were also lowered. No significant differences were observed for P-selectin, fibrinogen, VCAM-1, or ICAM-1 levels. Conclusions Patients in the convalescent phase of COVID-19 who received sulodexide for eight weeks showed a reduction in TM, vWF, D-dimer, CRP, and IL-6 serum levels compared to placebo. These findings suggest a potential protective effect of sulodexide against thromboinflammation and endothelial damage.https://doi.org/10.1177/10760296241297647 |
| spellingShingle | Alejandro J Gonzalez-Ochoa MD Gyozo Szolnoky MD Ana G Hernandez-Ibarra MD Jawed Fareed PhD Treatment with Sulodexide Downregulates Biomarkers for Endothelial Dysfunction in Convalescent COVID-19 Patients Clinical and Applied Thrombosis/Hemostasis |
| title | Treatment with Sulodexide Downregulates Biomarkers for Endothelial Dysfunction in Convalescent COVID-19 Patients |
| title_full | Treatment with Sulodexide Downregulates Biomarkers for Endothelial Dysfunction in Convalescent COVID-19 Patients |
| title_fullStr | Treatment with Sulodexide Downregulates Biomarkers for Endothelial Dysfunction in Convalescent COVID-19 Patients |
| title_full_unstemmed | Treatment with Sulodexide Downregulates Biomarkers for Endothelial Dysfunction in Convalescent COVID-19 Patients |
| title_short | Treatment with Sulodexide Downregulates Biomarkers for Endothelial Dysfunction in Convalescent COVID-19 Patients |
| title_sort | treatment with sulodexide downregulates biomarkers for endothelial dysfunction in convalescent covid 19 patients |
| url | https://doi.org/10.1177/10760296241297647 |
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