Defibrotide for the Treatment of Pediatric Inflammatory Multisystem Syndrome Temporally Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in 2 Pediatric Patients

Journal of the Pediatric Infectious Diseases Society - Tập 9 Số 5 - Trang 622-625 - 2020
Peter Lang1, Thomas Eichholz1, Tamam Bakchoul2, Monika Streiter3, Maurice Petrasch3, Hans Bösmüller4, Reinhild Klein5, Armin Rabsteyn1, Annemarie Lang1, Constantin Adams1, Karin Klingel4, Michaela Geßner1, Peter Rosenberger6, Peter Ruef3, Rupert Handgretinger1
1Children's University Hospital, Eberhard Karls University Tuebingen, Tuebingen, Germany
2Institute of Transfusion Medicine, Eberhard Karls University Tuebingen, Tuebingen, Germany
3Children's Hospital, SLK-Kliniken Heilbronn GmbH, Heilbronn, Germany
4Institute of Pathology, Eberhard Karls University Tuebingen, Tuebingen, Germany
5Department of Haematology/Oncology, Eberhard Karls University Tuebingen, Tuebingen, Germany
6University Hospital for Intensive Care and Anaesthesiology, Eberhard Karls University Tuebingen, Tuebingen, Germany

Tóm tắt

AbstractThe pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 infection is a severe complication of coronavirus disease 2019. Since impaired coagulation and thrombosis/endotheliitis are suspected pathomechanisms, we treated 2 patients with defibrotide, a profibrinolytic, antithrombotic, antiinflammatory oligonucleotide. Symptoms resolved during treatment. Moreover, coagulation parameters indicating hypofibrinolysis and complement activation normalized.The pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 infection is a severe complication of coronavirus disease 2019. Since impaired coagulation and thrombosis/endotheliitis are suspected pathomechanisms, 2 patients received defibrotide, a profibrinolytic, antithrombotic, antiinflammatory oligonucleotide. Symptoms resolved and hypofibrinolysis/complement activation normalized during treatment.

Từ khóa


Tài liệu tham khảo

Goh, 2020, Rapid progression to acute respiratory distress syndrome: review of current understanding of critical illness from COVID-19 infection, Ann Acad Med Singap, 49, 108, 10.47102/annals-acadmedsg.202057

Tang, 2020, Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia, J Thromb Haemost, 18, 844, 10.1111/jth.14768

Varga, 2020, Endothelial cell infection and endotheliitis in COVID-19, Lancet, 395, 1417, 10.1016/S0140-6736(20)30937-5

Riphagen, 2020, Hyperinflammatory shock in children during COVID-19 pandemic, Lancet, 395, 1607, 10.1016/S0140-6736(20)31094-1

Carreras, 2011, The role of the endothelium in the short-term complications of hematopoietic SCT, Bone Marrow Transplant, 46, 1495, 10.1038/bmt.2011.65

Richardson, 2013, Drug safety evaluation of defibrotide, Expert Opin Drug Saf, 12, 123, 10.1517/14740338.2012.749855

Pescador, 2013, Defibrotide: properties and clinical use of an old/new drug, Vascul Pharmacol, 59, 1, 10.1016/j.vph.2013.05.001

Shekerdemian, 2020, Characteristics and outcomes of children with coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian pediatric intensive care units, JAMA Pediatr, 10.1001/jamapediatrics.2020.1948

Feldstein, 2020, Multisystem inflammatory syndrome in U.S. children and adolescents, N Engl J Med, 383, 334, 10.1056/NEJMoa2021680

Wang, 2015, The role of C5a in acute lung injury induced by highly pathogenic viral infections, Emerg Microbes Infect, 4, e28, 10.1038/emi.2015.28

Magro, 2020, Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases, Transl Res, 220, 1, 10.1016/j.trsl.2020.04.007

Zhang, 2020, Immune phenotyping based on neutrophil-to-lymphocyte ratio and IgG predicts disease severity and outcome for patients with COVID-19, Front Mol Biosci, 10.3389/fmolb.2020.00157

Klok, 2020, Incidence of thrombotic complications in critically ill ICU patients with COVID-19, Thromb Res

Thông tin
Thông tin xuất bản

Journal of the Pediatric Infectious Diseases Society

Tập 9 Số 5

622-625

Thông tin tác giả