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Bussolari C, Palumbo D, Fominsky E, et al. Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019. Front Med (Lausanne). 2021;8:766486doi: 10.3389/fmed.2021.766486.
Bussolari, C., Palumbo, D., Fominsky, E., Nardelli, P., De Lorenzo, R., Vitali, G., De Cobelli, F., Rovere-Querini, P., & Scandroglio, A. M. (2021). Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019. Frontiers in medicine, 8766486. https://doi.org/10.3389/fmed.2021.766486
Bussolari, Cecilia, et al. "Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019." Frontiers in medicine vol. 8 (2021): 766486. doi: https://doi.org/10.3389/fmed.2021.766486
Bussolari C, Palumbo D, Fominsky E, Nardelli P, De Lorenzo R, Vitali G, De Cobelli F, Rovere-Querini P, Scandroglio AM. Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019. Front Med (Lausanne). 2021 Oct 28;8:766486. doi: 10.3389/fmed.2021.766486. eCollection 2021. PMID: 34778326; PMCID: PMC8581035.
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Front Med (Lausanne). 2021 Oct 28;8:766486. doi: 10.3389/fmed.2021.766486. eCollection 2021.

Case Report: Nintedaninb May Accelerate Lung Recovery in Critical Coronavirus Disease 2019.

Frontiers in medicine

Cecilia Bussolari, Diego Palumbo, Evgeni Fominsky, Pasquale Nardelli, Rebecca De Lorenzo, Giordano Vitali, Francesco De Cobelli, Patrizia Rovere-Querini, Anna Mara Scandroglio

Affiliations

  1. Vita-Salute San Raffaele University, Milan, Italy.
  2. Unit of Radiology, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital, Milan, Italy.
  3. Unit of Anesthesiology and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital, Milan, Italy.
  4. Division of Immunology, Transplantation and Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital, Milan, Italy.

PMID: 34778326 PMCID: PMC8581035 DOI: 10.3389/fmed.2021.766486

Abstract

Severe Coronavirus disease 2019 (COVID-19) is characterized by acute respiratory distress syndrome (ARDS) which may lead to long-lasting pulmonary sequelae in the survivors. COVID-19 shares common molecular signatures with interstitial lung diseases (ILDs), including pro-angiogenic and tissue-remodeling mechanisms mediated by vascular endothelial growth factor receptor (VEGF-R), fibroblast growth factor receptor (FGF-R), and platelet-derived growth factor receptor (PDGF-R). Nintedanib mainly targets these factors and is approved for ILDs. Therefore, we administered nintedanib through compassionate use to three patients with COVID-19 pneumonia requiring extra-corporeal membrane-oxygenation (ECMO). Here, we describe our experience in an attempt to explore the role of nintedanib in lung recovery in COVID-19. Three obese patients aged between 42 and 52 years were started on nintedanib due to difficulty in obtaining lung function restoration and weaning from ECMO support following the removal of orotracheal intubation (OTI). Soon after the start of the treatment, systemic inflammation and respiratory function rapidly improved and ECMO support was withdrawn. Serial chest CT scans confirmed the progressive lung amelioration, also reflected by functional tests during follow-up. Nintedanib was well-tolerated by all the three patients at the dosage used for ILDs and continued for 2-3 months based on drug availability. Although caution in interpreting events is required; it is tempting to speculate that nintedanib may have contributed to modulate lung inflammation and remodeling and to sustain lung repair. Altogether, nintedanib appears as a promising agent in patients with severe COVID-19 and delayed respiratory function recovery, for whom molecularly targeted therapies are still lacking. Clinical trials are necessary to confirm our observations.

Copyright © 2021 Bussolari, Palumbo, Fominsky, Nardelli, De Lorenzo, Vitali, De Cobelli, Rovere-Querini and Scandroglio.

Keywords: Coronavirus disease (COVID-19); antifibrotic therapy; lung inflammation; lung recovery; respiratory dysfunction; severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2)

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

  1. Respir Care. 2003 Aug;48(8):783-5 - PubMed
  2. Exp Cell Res. 1974 Aug;87(2):297-301 - PubMed
  3. Lancet Respir Med. 2020 Aug;8(8):807-815 - PubMed
  4. PLoS One. 2020 Oct 14;15(10):e0239570 - PubMed
  5. Rom J Morphol Embryol. 2018;59(2):455-467 - PubMed
  6. Acta Biomed. 2020 Jul 20;91(9-S):22-28 - PubMed
  7. Front Immunol. 2020 Jun 16;11:1446 - PubMed
  8. Front Immunol. 2020 Jun 26;11:1626 - PubMed
  9. Signal Transduct Target Ther. 2020 Sep 2;5(1):181 - PubMed
  10. Oncoimmunology. 2020 Aug 25;9(1):1807836 - PubMed
  11. J Leukoc Biol. 2021 Jan;109(1):55-66 - PubMed
  12. Lancet Respir Med. 2020 Aug;8(8):750-752 - PubMed
  13. Lung India. 2021 Mar;38(Supplement):S41-S47 - PubMed
  14. J Clin Med. 2020 Jun 19;9(6): - PubMed
  15. Mol Aspects Med. 2018 Aug;62:44-62 - PubMed
  16. N Engl J Med. 2014 May 29;370(22):2071-82 - PubMed
  17. Clin Microbiol Rev. 2021 Jan 13;34(2): - PubMed
  18. Front Med (Lausanne). 2017 Feb 28;4:13 - PubMed
  19. Panminerva Med. 2021 Jun 01;: - PubMed
  20. Eur Respir J. 2015 May;45(5):1434-45 - PubMed
  21. Thorax. 2020 Nov;75(11):1009-1016 - PubMed
  22. Crit Care. 2020 Jun 23;24(1):373 - PubMed

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