Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19: an investigator-initiated international meta-trial of randomised clinical studies
Frank M P Van Haren, Sarah J Valle, Ary Serpa Neto, Marcus J Schultz, John G Laffey, Antonio Artigas, Barry Dixon, Alicia B Vilaseca, Ruben A Barbera, Tarek I Ismail, Rabab S Mahrous, Mohamed Badr, Gilberto Denucci, Carlos Sverdloff, Marta Camprubi-Rimblas, David W Cosgrave, Bairbre Mcnicholas, Catriona Cody, Gerard Curley, Thomas L Smoot, Sabrina Staas, Khine Sann, Caitlin Sas, Anusha Belani, Christopher Hillman, Sidharta Kusuma Manggala, Dita Aditianingsih, Adhrie Sugiarto, Mira Yulianti, Herikurniawan Herikurniawan, Robert Sinto, Aino Nindya Auerkari, Septian Adi Permana, Ashley Woodcock, Mary Carroll, Tom Wilkinson, Dave Singh, Janis Kay Shute, Miles Carroll, Clive Page
eClinicalMedicine, doi:10.1016/j.eclinm.2025.103339
Background Inhaled nebulised unfractionated heparin (UFH) has a strong rationale as a treatment for severe respiratory infections, including COVID-19, due to its antiviral, anti-inflammatory, and anti-coagulant properties, which may prevent viral entry, lung injury progression, and pulmonary thrombosis. We aimed to evaluate the efficacy of inhaled nebulised UFH to prevent intubation or death in hospitalised COVID-19 patients.
Methods In this prospective, a priori set up and defined, collaborative meta-trial of six randomised clinical studies, adult hospitalised but not intubated COVID-19 patients were randomly assigned to inhaled nebulised UFH on top of
Ethics and registration The Argentinian study protocol was approved by the Independent Ethics Committee for Clinical Pharmacology Trials, Buenos Aires (ID N 3183).
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