Background Sulodexide has pleiotropic properties within the vascular endothelium that can prove beneficial for the treatment of patients with COVID-19. We aimed to evaluate the effect of sulodexide when used… Click to show full abstract
Background Sulodexide has pleiotropic properties within the vascular endothelium that can prove beneficial for the treatment of patients with COVID-19. We aimed to evaluate the effect of sulodexide when used in the early clinical stages of COVID-19. Methods In an outpatient setting, we conducted a randomized controlled trial with a parallel-group design. Including patients within three days of clinical onset, who were at a high risk of severe clinical progression due to chronic comorbidities. Participants were randomly assigned to receive an oral dose of sulodexide (500 LRU twice a day) or placebo for 21 days. Primary outcomes were need-length of hospitalization and need-length of oxygen support. Results Between June 5 and August 30, 2020, 243 patients were included in the per-protocol analysis. 124 of them received sulodexide, while 119 received placeboes. At 21 days follow-up, 17.7% patients required hospitalization in the sulodexide group compared to 29.4% in the placebo group, p=0.03. 29.8% required oxygen support in the sulodexide group vs 42% in the placebo group, p=0.05 and for fewer days [9 (7.2 SD) in the sulodexide group vs. 11.5 (9.6 SD) in the placebo group; p=0.02]. There was no between-group difference concerning the length of hospital stay. Interpretation Early intervention in COVID-19 patients with sulodexide reduced hospital admissions and oxygen support requirements. This has beneficial implications in the patient's well-being, making sulodexide a favorable medication until an effective vaccine or an antiviral becomes available. Funding Researcher independently initiated, partially funded by Alfasigma, Mexico. ISRCTN registry listed under ID ISRCTN59048638.
               
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