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dc.contributor.author | Clemente-Moragón, Agustín | |
dc.contributor.author | Martínez-Milla, Juan | |
dc.contributor.author | Oliver, Eduardo | |
dc.contributor.author | Santos, Arnoldo | |
dc.contributor.author | Flandes, Javier | |
dc.contributor.author | Fernández, Iker | |
dc.contributor.author | Rodríguez-González, Lorena | |
dc.contributor.author | Serrano Del Castillo, Cristina | |
dc.contributor.author | Ioan, Ana-María | |
dc.contributor.author | López-Álvarez, María | |
dc.contributor.author | Gómez-Talavera, Sandra | |
dc.contributor.author | Galán-Arriola, Carlos | |
dc.contributor.author | Fuster, Valentin | |
dc.contributor.author | Pérez-Calvo, César | |
dc.contributor.author | Ibáñez, Borja | |
dc.date.accessioned | 2023-07-06T10:13:10Z | |
dc.date.available | 2023-07-06T10:13:10Z | |
dc.date.issued | 2021-09-07 | |
dc.identifier.citation | J Am Coll Cardiol. 2021 Sep 7;78(10):1001-1011 | es_ES |
dc.identifier.uri | http://hdl.handle.net/20.500.12105/16212 | |
dc.description.abstract | Severe coronavirus disease-2019 (COVID-19) can progress to an acute respiratory distress syndrome (ARDS), which involves alveolar infiltration by activated neutrophils. The beta-blocker metoprolol has been shown to ameliorate exacerbated inflammation in the myocardial infarction setting. The purpose of this study was to evaluate the effects of metoprolol on alveolar inflammation and on respiratory function in patients with COVID-19-associated ARDS. A total of 20 COVID-19 patients with ARDS on invasive mechanical ventilation were randomized to metoprolol (15 mg daily for 3 days) or control (no treatment). All patients underwent bronchoalveolar lavage (BAL) before and after metoprolol/control. The safety of metoprolol administration was evaluated by invasive hemodynamic and electrocardiogram monitoring and echocardiography. Metoprolol administration was without side effects. At baseline, neutrophil content in BAL did not differ between groups. Conversely, patients randomized to metoprolol had significantly fewer neutrophils in BAL on day 4 (median: 14.3 neutrophils/µl [Q1, Q3: 4.63, 265 neutrophils/µl] vs median: 397 neutrophils/µl [Q1, Q3: 222, 1,346 neutrophils/µl] in the metoprolol and control groups, respectively; P = 0.016). Metoprolol also reduced neutrophil extracellular traps content and other markers of lung inflammation. Oxygenation (PaO2:FiO2) significantly improved after 3 days of metoprolol treatment (median: 130 [Q1, Q3: 110, 162] vs median: 267 [Q1, Q3: 199, 298] at baseline and day 4, respectively; P = 0.003), whereas it remained unchanged in control subjects. Metoprolol-treated patients spent fewer days on invasive mechanical ventilation than those in the control group (15.5 ± 7.6 vs 21.9 ± 12.6 days; P = 0.17). In this pilot trial, intravenous metoprolol administration to patients with COVID-19-associated ARDS was safe, reduced exacerbated lung inflammation, and improved oxygenation. Repurposing metoprolol for COVID-19-associated ARDS appears to be a safe and inexpensive strategy that can alleviate the burden of the COVID-19 pandemic. | es_ES |
dc.description.sponsorship | Mr Clemente-Moragón is supported by a fellowship from the Ministerio de Ciencia e Innovación (FPU2017/01932). The CNIC is supported by the ISCIII, the Ministerio de Ciencia e Innovación, and the Pro CNIC Foundation. Dr Ibáñez is supported by the European Commission (ERC-CoG grant No 819775) and by the Spanish Ministry of Science and Innovation (MCN; “RETOS 2019” grant No PID2019- 107332RB-I00). Dr Oliver is supported by funds from the Comunidad de Madrid Programa de Atracción de Talento (2017-T1/BMD-5185). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | Elsevier | es_ES |
dc.type.hasVersion | VoR | es_ES |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject.mesh | Pandemics | es_ES |
dc.subject.mesh | SARS-CoV-2 | es_ES |
dc.subject.mesh | Adrenergic beta-1 Receptor Antagonists | es_ES |
dc.subject.mesh | Adult | es_ES |
dc.subject.mesh | Aged | es_ES |
dc.subject.mesh | COVID-19 | es_ES |
dc.subject.mesh | Critical Illness | es_ES |
dc.subject.mesh | Female | es_ES |
dc.subject.mesh | Humans | es_ES |
dc.subject.mesh | Injections, Intravenous | es_ES |
dc.subject.mesh | Male | es_ES |
dc.subject.mesh | Metoprolol | es_ES |
dc.subject.mesh | Middle Aged | es_ES |
dc.subject.mesh | Pilot Projects | es_ES |
dc.subject.mesh | Prospective Studies | es_ES |
dc.subject.mesh | Respiration, Artificial | es_ES |
dc.title | Metoprolol in Critically Ill Patients With COVID-19. | es_ES |
dc.type | journal article | es_ES |
dc.rights.license | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.identifier.pubmedID | 34474731 | es_ES |
dc.format.volume | 78 | es_ES |
dc.format.number | 10 | es_ES |
dc.format.page | 1001 | es_ES |
dc.identifier.doi | 10.1016/j.jacc.2021.07.003 | es_ES |
dc.contributor.funder | Ministerio de Ciencia e Innovación (España) | es_ES |
dc.contributor.funder | Instituto de Salud Carlos III | es_ES |
dc.contributor.funder | Fundación ProCNIC | es_ES |
dc.contributor.funder | Unión Europea. Comisión Europea. European Research Council (ERC) | es_ES |
dc.contributor.funder | Comunidad de Madrid (España) | es_ES |
dc.description.peerreviewed | Sí | es_ES |
dc.identifier.e-issn | 1558-3597 | es_ES |
dc.relation.publisherversion | https://doi.org/10.1016/j.jacc.2021.07.003 | es_ES |
dc.identifier.journal | Journal of the American College of Cardiology | es_ES |
dc.repisalud.orgCNIC | CNIC::Grupos de investigación::Laboratorio Traslacional para la Imagen y Terapia Cardiovascular | es_ES |
dc.repisalud.institucion | CNIC | es_ES |
dc.relation.projectID | info:eu-repo/grantAgreement/EC/H2020/ERC/CoG/819775 | es_ES |
dc.rights.accessRights | open access | es_ES |
dc.relation.projectFECYT | info:eu-repo/grantAgreement/ES/FPU2017/01932 | es_ES |
dc.relation.projectFECYT | info:eu-repo/grantAgreement/ES/PID2019-107332RB-I00 | es_ES |
dc.relation.projectFECYT | info:eu-repo/grantAgreement/ES/2017-T1/BMD-5185 | es_ES |