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Potential therapeutic effects of dipyridamole in the severely ill patients with COVID-19


Liu, X; Li, Z; Liu, S; Sun, J; Chen, Z; Jiang, M; Zhang, Q; Wei, Y; Wang, X; Huang, YY; Shi, Y; Xu, Y; Xian, H; Bai, F; Ou, C; Xiong, B; Lew, AM; Cui, J; Fang, R; Huang, H; Zhao, J; Hong, X; Zhang, Y; Zhou, F; Luo, HB
2020-04-20
Acta Pharmaceutica Sinica B
Journal epub ahead of print
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause acute respiratory distress syndrome, hypercoagulability, hypertension, and multiorgan dysfunction. Effective antivirals with safe clinical profile are urgently needed to improve the overall prognosis. In an analysis of a randomly collected cohort of 124 patients with Corona Virus Disease 2019 (COVID-19), we found that hypercoagulability as indicated by elevated concentrations of D-dimers was associated with disease severity. By virtual screening of a U.S. Food and Drug Administration (FDA) approved drug library, we identified an anticoagulation agent dipyridamole (DIP) in silico, which suppressed SARS-CoV-2 replication in vitro. In a proof-of-concept trial involving 31 patients with COVID-19, DIP supplementation was associated with significantly decreased concentrations of D-dimers (P<0.05), increased lymphocyte and platelet recovery in the circulation, and markedly improved clinical outcomes in comparison to the control patients. In particular, all 8 of the DIP-treated severely ill patients showed remarkable improvement: 7 patients (87.5%) achieved clinical cure and were discharged from the hospitals while the remaining 1 patient (12.5%) was in clinical remission.
Elsevier
Immunology
10.1016/j.apsb.2020.04.008
32318327
Refer to article for additional funding acknowledgements
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Creation Date 2020-05-04 10:30:34 Last Modified 2020-05-04 10:50:07