Evaluation of the effect of aminophylline on inflammatory parameters in COVID-19 patients with acute respiratory distress syndrome
DOI:
https://doi.org/10.46542/pe.2024.243.135140Keywords:
Aminophylline, ARDS, COVID-19, Inflammation, MortalityAbstract
Background: In Acute respiratory distress syndrome (ARDS), invasion and activation of pro- and anti-inflammatory mediators and cytokines result in oxidative damage to the lung tissue. Aminophylline is a combination of theophylline and ethyl diamine, has anti-inflammatory, bronchodilator, ROS inhibitor effects, and stimulates surfactant release. Mortality of ARDS in COVID-19 patients is high; aminophylline is expected to reduce the incidence of mortality. Information regarding the use of aminophylline in COVID-19 patients with ARDS is still limited.
Objective: To evaluate the efficacy of aminophylline in inflammatory parameters in COVID-19 patients with ARDS.
Methods: It was a retrospective cohort observational study at the Universitas Airlangga Hospital. Samples were hospitalised COVID-19 patients with ARDS who received a loading dose of 240-480 mg and a maintenance dose of 720-960 mg aminophylline. The primary outcomes were improved C-reactive protein (CRP), IL-6, lymphocytes, neutrophils, and Neutrophil-lymphocyte ratio (NLR), which were measured before and after administration of aminophylline with a duration of therapy of 1-5 days.
Result: A total of 50 patients with ARDS were enrolled in the study. Lymphocyte and CRP decreased (p = 0.002; p = 0.128). IL-6, neutrophil, and NLR increased (p = 0.255; p = 0.064; p = 0.005).
Conclusion: It can be concluded that the administration of aminophylline has not improved inflammatory parameters.
References
Aslan, A., Aslan, C., Zolbanin, N. M., & Jafari, R. (2021). Acute respiratory distress syndrome in COVID-19: Possible mechanisms and therapeutic management. Pneumonia, 13, 14. https://doi.org/10.1186/s41479-021-00092-9
Budiarti, T. N., Puspitasari, A. D., Rosyid, A. N., Indriani, D., Melaniani, S., Satryo, F. Z. O., Aina, L., Ardianto, N., Rachman, M. P. A., & Meiliani, F. (2022). Insomnia among Covid-19 patients during isolation treatment in inpatient room of Indonesian health care facilities. Media Kesehatan Masyarakat Indonesia, 18(1), 18–25. https://doi.org/10.30597/mkmi.v18i1.19109
Costa, V. O., Nicolini, E. M., Da Costa, B. M. A., Teixeira, F. M., Ferreira, J. P., Moura, M. A., Montessi, J., Campos, R. L., Guaraldo, A. N., & Costa, P. M. (2021). Evaluation of the risk of clinical deterioration among inpatients with COVID-19. Advances in Virology, 2021, 1–7. https://doi.org/10.1155/2021/6689669
Fatoni, A. Z., & Rakhmatullah, R. (2021). Acute Respiratory Distress Syndrome (ARDS) pada pneumonia COVID-19. Journal of Anaesthesia and Pain, 2(1), 11–24. https://doi.org/10.21776/ub.jap.2021.002.01.02
Fernando, S. M., Ferreyro, B. L., Urner, M., Munshi, L., & Fan, E. (2021). Diagnosis and management of acute respiratory distress syndrome. Canadian Medical Association Journal, 193(21), E761–E768. https://doi.org/10.1503/cmaj.202661
Gahart, B. L., Adriene, R. N., & Meghan, Q. O. (2019). Gahart's 2019 intravenous medications: A handbook for nurses and health professionals 35th Edition. Elsevier.
Ge, H., Wang, X., Yuan, X., Xiao, G., Wang, C., Deng, T., Yuan, Q., & Xiao, X. (2020). The epidemiology and clinical information about COVID-19. European Journal of Clinical Microbiology and Infectious Diseases, 39(6), 1011–1019. https://doi.org/10.1007/s10096-020-03874-z
Khalaf, J. M., Hussein, I. I., & Al-Nimer, M. S. (2021). Aminophylline as anti-hypoxic add-on therapy in the management of COVID-19 in Baghdad: An experience from single center report case study. Journal of Research in Pharmacy. 25(6), 852–6. https://doi.org/10.29228/jrp.80
Kosutova, P., Mikolka, P., Mokra, D., & Calkovska, A. (2023). Anti-inflammatory activity of non-selective PDE inhibitor aminophylline on the lung tissue and respiratory parameters in animal model of ARDS. Journal of Inflammation (United Kingdom), 20(1), 10. https://doi.org/10.1186/s12950-023-00337-y
Kusumawardani, L. A., Maria, N., & Amarta, Y. (2023). Adverse drug reactions evaluation of antimicrobials in COVID-19 inpatients using Modified Trigger Tool and Naranjo Algorithm. Pharmacy Education, 23(2), 1–8. https://doi.org/10.46542/pe.2023.232.18
Mokra, D., & Mokry, J. (2021). Phosphodiesterase inhibitors in acute lung injury: What are the perspectives? International Journal of Molecular Sciences, 22(4), 1929. https://doi.org/10.3390/ijms22041929
Montaño, L. M., Sommer, B., Gomez-Verjan, J. C., Morales-Paoli, G. S., Ramírez-Salinas, G. L., Solís-Chagoyán, H., Sanchez-Florentino, Z. A., Calixto, E., Pérez-Figueroa, G. E., Carter, R., Jaimez-Melgoza, R., Romero-Martínez, B. S., & Flores-Soto, E. (2022). Theophylline: Old drug in a new light, application in COVID-19 through computational studies. International Journal of Molecular Sciences, 23(8), 4167. https://doi.org/10.3390/ijms23084167
Mower, W. R., Sachs, C., Nicklin, E. L., Safa, P., & Baraff, L. J. (1996). A comparison of pulse oximetry and respiratory rate in patient screening. Respiratory Medicine. 90(10), 593–599. https://doi.org/10.1016/s0954-6111(96)90017-7
Patria, Y. N., & Sabirin, R. M. (2021). COVID-19 potentially causes long-term deterioration of lung function: A systematic review and meta-analysis. Medical Journal of Indonesia, 30(4), 279–289. https://doi.org/10.13181/mji.oa.215660
Pfortmueller, C. A., Spinetti, T., Urman, R. D., Luedi, M. M., & Schefold, J. C. (2021). COVID-19-associated acute respiratory distress syndrome (CARDS): Current knowledge on pathophysiology and ICU treatment – A narrative review. Best Practice and Research Clinical Anaesthesiology, 35(3), 351–368. https://doi.org/10.1016/j.bpa.2020.12.011
Rahmawati, C., Nurbaety, B., Qiyaam, N., Dini, S., & Maftuhah, L. (2022). Cost of illness for COVID-19 inpatients in West Nusa Tenggara, Indonesia. Pharmacy Education, 22(2), 66–69. https://doi.org/10.46542/pe.2022.222.6669
Regolo, M., Vaccaro, M., Sorce, A., Stancanelli, B., Colaci, M., Natoli, G., …., Malatino, L. (2022). Neutrophil-to-Lymphocyte Ratio (NLR) is a promising predictor of mortality and admission to intensive care unit of COVID-19 patients. Journal of Clinical Medicine. 11(8), 2235.https://doi.org/10.3390/jcm11082235
Siordia, J. A. (2020). Epidemiology and clinical features of COVID-19: A review of current literature. Journal of Clinical Virology, 127(2020), 104357. https://doi.org/10.1016/j.jcv.2020.104357
Welker, C., Huang, J., Nunez Gil, I. J., & Ramakrishna, H. (2022). Acute respiratory distress syndrome update, with coronavirus sisease 2019 focus. Journal of Cardiothoracic and Vascular Anesthesia, 36(4), 1188‒1195. https://doi.org/10.1053/j.jvca.2021.02.053
