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4. Inhaled aprotinin reduces viral load in mild‐to‐moderate inpatients with SARS‐CoV‐2 infection.

Author

Redondo‐Calvo, Francisco Javier, Padín, Juan Fernando, Martínez‐Alarcón, José, Muñoz‐Rodríguez, José Ramón, Serrano‐Oviedo, Leticia, López‐Juárez, Pilar, Porras Leal, María Lourdes, González Gasca, Francisco Javier, Rodríguez Martínez, Marta, Pérez Serrano, Raúl, Sánchez Cadena, Abraham, Bejarano‐Ramírez, Natalia, Muñoz Hornero, Constanza, Villegas Fernández‐Infantes, María Dolores, Manrique Romo, María Isabel, Gómez‐Romero, Francisco Javier, Pérez‐Ortiz, José Manuel, Bodoque‐Villar, R., Pulido‐Sánchez, G., and Illescas Fernández‐Bermejo, M. S.

Subjects
APROTININ, VIRAL load, SARS-CoV-2, COVID-19, CLINICAL trials
Published
2022
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5. Aprotinin treatment against SARS‐CoV‐2: A randomized phase III study to evaluate the safety and efficacy of a pan‐protease inhibitor for moderate COVID‐19.

Author

Redondo‐Calvo, Francisco Javier, Padín, Juan Fernando, Muñoz‐Rodríguez, José Ramón, Serrano‐Oviedo, Leticia, López‐Juárez, Pilar, Porras Leal, María Lourdes, González Gasca, Francisco Javier, Rodríguez Martínez, Marta, Pérez Serrano, Raúl, Sánchez Cadena, Abraham, Bejarano‐Ramírez, Natalia, Muñoz Hornero, Constanza, Barberá Farré, José Ramón, Domínguez‐Quesada, Inmaculada, Sepúlveda Berrocal, María A., Villegas Fernández‐Infantes, María  Dolores, Manrique Romo, María Isabel, Parra Comino, Ángel, Pérez‐Ortiz, José Manuel, and Gómez‐Romero, Francisco Javier

Subjects
APROTININ, COVID-19, SARS-CoV-2, TREATMENT effectiveness, LENGTH of stay in hospitals
Abstract

Background: SARS‐CoV‐2 virus requires host proteases to cleave its spike protein to bind to its ACE2 target through a two‐step furin‐mediated entry mechanism. Aprotinin is a broad‐spectrum protease inhibitor that has been employed as antiviral drug for other human respiratory viruses. Also, it has important anti‐inflammatory properties for inhibiting the innate immunity contact system. Methods: This was a multicentre, double‐blind, randomized trial performed in four Spanish hospitals comparing standard treatment versus standard treatment + aprotinin for patients with COVID‐19 between 20 May 2020 and 20 October 2021. The primary efficacy outcomes were length of hospital stay and ICU admission. The secondary endpoints were each of the primary efficacy outcomes and a composite of oxygen therapy, analytical parameters and death. Safety outcomes included adverse reactions to treatment during a 30‐day follow‐up period. Treatment was given for 11 days or till discharge. Results: With almost identical analytical profiles, significant differences were observed in treatment time, which was 2 days lower in the aprotinin group (p =.002), and length of hospital admission, which was 5 days shorter in the aprotinin group (p =.003). The incidence of discharge was 2.19 times higher (HR: 2.188 [1.182–4.047]) in the aprotinin group than in the placebo group (p =.013). In addition, the aprotinin‐treated group required less oxygen therapy and had no adverse reactions or side effects. Conclusion: Inhaled aprotinin may improve standard treatment and clinical outcomes in hospitalized patients with COVID‐19, resulting in a shorter treatment time and hospitalization compared with the placebo group. The administration of aprotinin was safe. [ABSTRACT FROM AUTHOR]

Published
2022
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