1. MUlticenter STudy of tissue plasminogen activator (alteplase) use in COVID‐19 severe respiratory failure (MUST COVID): A retrospective cohort study
- Author
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Christopher D. Barrett, Hunter B. Moore, Ernest E. Moore, Dudley Benjamin Christie III, Sarah Orfanos, Lorenzo Anez‐Bustillos, Rashi Jhunjhunwala, Sabiha Hussain, Shahzad Shaefi, Janice Wang, Negin Hajizadeh, Elias N. Baedorf‐Kassis, Ammar Al‐Shammaa, Krystal Capers, Valerie Banner‐Goodspeed, Franklin L. Wright, Todd Bull, Peter K. Moore, Hannah Nemec, John Thomas Buchanan, Cory Nonnemacher, Natalie Rajcooar, Ramona Ramdeo, Mena Yacoub, Ana Guevara, Aileen Espinal, Laith Hattar, Andrew Moraco, Robert McIntyre, Daniel S. Talmor, Angela Sauaia, and Michael B. Yaffe
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Abstract Background Few therapies exist to treat severe COVID‐19 respiratory failure once it develops. Given known diffuse pulmonary microthrombi on autopsy studies of COVID‐19 patients, we hypothesized that tissue plasminogen activator (tPA) may improve pulmonary function in COVID‐19 respiratory failure. Methods A multicenter, retrospective, observational study of patients with confirmed COVID‐19 and severe respiratory failure who received systemic tPA (alteplase) was performed. Seventy‐nine adults from seven medical centers were included in the final analysis after institutional review boards' approval; 23 were excluded from analysis because tPA was administered for pulmonary macroembolism or deep venous thrombosis. The primary outcome was improvement in the PaO2/FiO2 ratio from baseline to 48 h after tPA. Linear mixed modeling was used for analysis. Results tPA was associated with significant PaO2/FiO2 improvement at 48 h (estimated paired difference = 23.1 ± 6.7), which was sustained at 72 h (interaction term p
- Published
- 2022
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