Gonzalez-Ochoa Alejandro J, Szolnoky Gyozo, Hernandez-Ibarra Ana G, Fareed Jawed
Vascular Surgery Department, Centro Médico del Noroeste, San Luis Rio Colorado, Sonora, México.
Vascular and Endovascular Surgery department, CLINEDEM, San Luis Rio Colorado, Sonora, México.
Clin Appl Thromb Hemost. 2025 Jan-Dec;31:10760296241297647. doi: 10.1177/10760296241297647.
Persistent elevation of biomarkers associated with endothelial dysfunction in convalescent COVID-19 patients has been linked to an increased risk of long-term cardiovascular complications, including long COVID syndrome. Sulodexide, known for its vascular endothelial affinity, has demonstrated pleiotropic protective properties. This study aims to evaluate the impact of sulodexide on serum levels of endothelial dysfunction biomarkers in patients during the convalescent phase of COVID-19.
We conducted a double-blind, single-center, randomized, placebo-controlled trial in Mexico, comparing sulodexide (250 LRU orally, twice daily) with placebo over 8 weeks in adult patients during early COVID-19 convalescence. Differences in serum biomarkers between the groups were analyzed using repeated measures and post hoc tests, with Thrombomodulin (TM) as the primary endpoint.
Among 206 analyzed patients (103 in each group), at week 8, the sulodexide group exhibited significantly lower mean levels of Thrombomodulin (TM) (25.2 ± 7.9 ng/mL vs 29.9 ± 14.7 ng/mL, = .03), von Willebrand Factor (vWF) (232 ± 131 U/dL vs 266 ± 122 U/dL, = .02) and Interleukin-6 (IL-6) (12.5 ± 13.2 pg/mL vs 16.2 ± 16.5 pg/mL, = .03) compared to the placebo group. D-dimer and C reactive protein (CRP) in the sulodexide group were also lowered. No significant differences were observed for P-selectin, fibrinogen, VCAM-1, or ICAM-1 levels.
Patients in the convalescent phase of COVID-19 who received sulodexide for eight weeks showed a reduction in TM, vWF, D-dimer, CRP, and IL-6 serum levels compared to placebo. These findings suggest a potential protective effect of sulodexide against thromboinflammation and endothelial damage.
康复期新冠病毒感染患者中，与内皮功能障碍相关的生物标志物持续升高与包括新冠后综合征在内的长期心血管并发症风险增加有关。舒洛地昔因其对血管内皮的亲和力而闻名，已显示出多效性保护特性。本研究旨在评估舒洛地昔对新冠病毒感染康复期患者血清内皮功能障碍生物标志物水平的影响。
我们在墨西哥进行了一项双盲、单中心、随机、安慰剂对照试验，在成年患者新冠病毒感染早期康复期将舒洛地昔（口服250 LRU，每日两次）与安慰剂进行了为期8周的比较。使用重复测量和事后检验分析两组之间血清生物标志物的差异，以血栓调节蛋白（TM）作为主要终点。
在206例分析患者中（每组103例），在第8周时，与安慰剂组相比，舒洛地昔组的血栓调节蛋白（TM）平均水平显著降低（25.2±7.9 ng/mL对29.9±14.7 ng/mL，P = 0.03）、血管性血友病因子（vWF）（232±131 U/dL对266±122 U/dL，P = 0.02）和白细胞介素-6（IL-6）（12.5±13.2 pg/mL对16.2±16.5 pg/mL，P = 0.03）。舒洛地昔组的D-二聚体和C反应蛋白（CRP）也有所降低。P-选择素、纤维蛋白原、血管细胞黏附分子-1或细胞间黏附分子-1水平未观察到显著差异。
与安慰剂相比，接受舒洛地昔治疗8周的新冠病毒感染康复期患者的TM、vWF、D-二聚体、CRP和IL-6血清水平降低。这些发现表明舒洛地昔对血栓炎症和内皮损伤具有潜在的保护作用。
