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Br J Clin Pharmacol ; 89(4): 1495-1501, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36437688

RESUMO

COVID-19 causes significant thrombosis and coagulopathy, with elevated D-dimer a predictor of adverse outcome. The precise mechanism of this coagulopathy remains unclear; one hypothesis is that loss of angiotensin-converting enzyme 2 activity during viral endocytosis leads to pro-inflammatory angiotensin-II accumulation, loss of angiotensin-1-7 and subsequent vascular endothelial activation. We undertook a double-blind randomized, placebo-controlled experimental medicine study to assess the effect of TRV027, a synthetic angiotensin-1-7 analogue on D-dimer in 30 patients admitted to hospital with COVID-19. The study showed a similar rate of adverse events in TRV027 and control groups. There was a numerical decrease in D-dimer in the TRV027 group and increase in D-dimer in the placebo group; however, this did not reach statistical significance (P = .15). A Bayesian analysis demonstrated that there was a 92% probability that this change represented a true drug effect.


Assuntos
Transtornos da Coagulação Sanguínea , COVID-19 , Humanos , Teorema de Bayes , Projetos Piloto , Angiotensinas , Método Duplo-Cego , Resultado do Tratamento
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