Background Mechanically ventilated patients with COVID-19 have a mortality of 24–53%, in part due to distal mucopurulent secretions interfering with ventilation. DNA from neutrophil extracellular traps (NETs) contribute to the viscosity of mucopurulent secretions and NETs are found in the serum of COVID-19 patients. Dornase alfa is recombinant human DNase 1 and is used to digest DNA in mucoid sputum. Here, we report a single-center case series where dornase alfa was co-administered with albuterol through an in-line nebulizer system. Methods Demographic and clinical data were collected from the electronic medical records of five mechanically ventilated patients with COVID-19—including three requiring veno-venous extracorporeal membrane oxygenation—treated with nebulized in-line endotracheal dornase alfa and albuterol, between March 31 and April 24, 2020. Data on tolerability and response were analyzed. Results The fraction of inspired oxygen requirements was reduced for all five patients after initiating dornase alfa administration. All patients were successfully extubated, discharged from hospital and remain alive. No drug-associated toxicities were identified. Conclusions Results suggest that dornase alfa will be well-tolerated by patients with severe COVID-19. Clinical trials are required to formally test the dosing, safety, and efficacy of dornase alfa in COVID-19, and several have been recently registered.
【저자키워드】 COVID-19, SARS-CoV-2, ARDS, coronavirus, Mucopurulent secretions, Dornase alfa, Neutrophil extracellular traps, VV-ECMO, 【초록키워드】 Efficacy, Mortality, Trial, severe COVID-19, Mucopurulent secretions, Dornase alfa, Neutrophil extracellular traps, hospital, neutrophil, Ventilation, clinical trials, Toxicity, oxygen, sputum, mechanically ventilated patients, DNA, serum, clinical, Patient, Neutrophil extracellular trap, membrane, electronic medical records, demographic, NETs, COVID-19 patients, Dosing, administration, medical records, mucoid sputum, Tolerability, Clinical data, toxicities, Registered, single-center, fraction, albuterol, in-line nebulizer system, nebulized, veno-venous extracorporeal membrane oxygenation, viscosity, Oxygen requirement, NET, FIVE, electronic medical record, Result, analyzed, collected, required, case sery, contribute, discharged, was reduced, distal, DNase 1, mechanically ventilated patient, mucopurulent secretion, ventilated patient, with COVID-19, 【제목키워드】 Dornase alfa, mechanically ventilated, Administered, case sery,