Effect of montelukast therapy on clinical course, pulmonary function, and mortality in patients with COVID-19.
COVID-19
montelukast
pulmonary function tests
Journal
Journal of medical virology
ISSN: 1096-9071
Titre abrégé: J Med Virol
Pays: United States
ID NLM: 7705876
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
revised:
21
12
2021
received:
09
10
2021
accepted:
23
12
2021
pubmed:
28
12
2021
medline:
24
3
2022
entrez:
27
12
2021
Statut:
ppublish
Résumé
The inflammatory/anti-inflammatory balance has an important role in the clinical course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) infection, which has affected over 200 million people since it first appeared in China in December 2019. This study aimed to determine the effectiveness of montelukast, which has known anti-inflammatory and bronchodilatory effects, in these patients. The prospective randomized controlled study included 180 patients who were hospitalized in the infectious diseases department of our hospital between May and July 2021 and were diagnosed with the delta variant of SARS-CoV-2 by real-time polymerase chain reaction of nasopharyngeal swabs. The patients were divided into three groups and received only standard treatment according to national guidelines (Group 1) or standard treatment plus 10 mg/day montelukast (Group 2) or 20 mg/day montelukast (Group 3). Laboratory parameters and pulmonary function tests (PFTs) at admission and on Day 5 of treatment were compared. Comparison of laboratory parameters on Day 5 showed that Groups 2 and 3 had significantly lower levels of lactate dehydrogenase, fibrinogen, D-dimer, C-reactive protein, and procalcitonin compared with Group 1 (p = 0.04, 0.002, 0.05, 0.03, and 0.04, respectively). In the comparison between Groups 2 and 3, only fibrinogen was significantly lower in Group 3 (p = 0.02). PFT results did not differ between the groups at admission, while on Day 5, only Group 3 showed significant improvements in forced expiratory volume in 1 s, forced vital capacity, and peak expiratory flow 25-75 compared with admission (p = 0.001 for all). Montelukast may be beneficial in COVID-19 patients to maintain the inflammatory/anti-inflammatory balance, prevent respiratory failure through its bronchodilator activity, and reduce mortality.
Identifiants
pubmed: 34958142
doi: 10.1002/jmv.27552
pmc: PMC9015221
doi:
Substances chimiques
Acetates
0
Cyclopropanes
0
Quinolines
0
Sulfides
0
montelukast
MHM278SD3E
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
1950-1958Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: a review. Clin Immunol. 2020;215:108427.
Kerget B, Kerget F, Aksakal A, Aşkın S, Sağlam L, Akgün M. Evaluation of alpha defensin, IL-1 receptor antagonist, and IL-18 levels in COVID-19 patients with macrophage activation syndrome and acute respiratory distress syndrome. J Med Virol. 2021;93(4):2090-2098.
Kerget B, Kerget F, Koçak AO, et al. Are serum interleukin 6 and surfactant protein D levels associated with the clinical course of COVID-19? Lung. 2020;198(5):777-784.
Wu A, Chik S, Chan A, Li Z, Tsang K, Li W. Anti-inflammatory effects of high-dose montelukast in an animal model of acute asthma. Clin Exp Allergy. 2003;33(3):359-366.
Pizzichini E, Leff JA, Reiss TF, et al. Montelukast reduces airway eosinophilic inflammation in asthma: a randomized, controlled trial. Eur Respir J. 1999;14(1):12-18.
Graham BL, Steenbruggen I, Miller MR, et al. Standardization of spirometry 2019 update. An official American thoracic society and European respiratory society technical statement. Am J Respir Crit Care Med. 2019;200(8):e70-e88.
Brodeur A, Gray D, Islam A, Bhuiyan S. A literature review of the economics of COVID-19. J Econ Surv. 2021;35(4):1007-1044.
He R, Lu Z, Zhang L, et al. The clinical course and its correlated immune status in COVID-19 pneumonia. J Clin Virol. 2020;127:104361.
Vaninov N. In the eye of the COVID-19 cytokine storm. Nat Rev Immunol. 2020;20(5):277
Kircheis R, Haasbach E, Lueftenegger D, Heyken WT, Ocker M, Planz O. NF-κB pathway as a potential target for treatment of critical stage COVID-19 patients. Front Immunol. 2020;11:3446.
Sanghai N, Tranmer GK. Taming the cytokine storm: repurposing montelukast for the attenuation and prophylaxis of severe COVID-19 symptoms. Drug Discovery Today. 2020;25:2076-2079.
Wisastra R, Dekker FJ. Inflammation, cancer and oxidative lipoxygenase activity are intimately linked. Cancers. 2014;6(3):1500-1521.
Yu G-L, Wei E-Q, Zhang S-H, et al. Montelukast, a cysteinyl leukotriene receptor-1 antagonist, dose-and time-dependently protects against focal cerebral ischemia in mice. Pharmacology. 2005;73(1):31-40.
Davidson AM, Wysocki J, Batlle D. Interaction of SARS-CoV-2 and other coronavirus with ACE (angiotensin-converting enzyme)−2 as their main receptor: therapeutic implications. Hypertension. 2020;76(5):1339-1349.
Fidan C, Aydoğdu A. As a potential treatment of COVID-19: montelukast. Med Hypotheses. 2020;142:109828.
Lee JY, Nguyen TTN, Myoung J. Zika virus-encoded NS2A and NS4A strongly downregulate NF-κB promoter activity. J Microbiol Biotechnol. 2020;30(11):1651-1658.
Chen Y, Li Y, Wang X, Zou P. Montelukast, an anti-asthmatic drug, inhibits zika virus infection by disrupting viral integrity. Front Microbiol. 2020;10:3079.
Bisgaard H. A randomized trial of montelukast in respiratory syncytial virus postbronchiolitis. Am J Respir Crit Care Med. 2003;167(3):379-383.