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Treatment with Sulodexide Downregulates Biomarkers for Endothelial Dysfunction in Convalescent COVID-19 Patients

Alejandro J Gonzalez-Ochoa1,2, Gyozo Szolnoky3, Ana G Hernandez-Ibarra4

  • 1Vascular Surgery Department, Centro Médico del Noroeste, San Luis Rio Colorado, Sonora, México.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|January 7, 2025
PubMed

Insights

Sulodexide reduced key endothelial dysfunction biomarkers like Thrombomodulin and von Willebrand Factor in convalescent COVID-19 patients. This suggests sulodexide may protect against long COVID-related vascular issues.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Infectious Diseases

Background:

  • Persistent endothelial dysfunction biomarkers post-COVID-19 are linked to long-term cardiovascular risks, including long COVID syndrome.
  • Sulodexide possesses vascular endothelial affinity and protective properties.
  • Evaluating sulodexide's impact on endothelial dysfunction biomarkers in COVID-19 convalescence is crucial.

Purpose of the Study:

  • To assess the efficacy of sulodexide in mitigating endothelial dysfunction markers during the COVID-19 convalescent phase.
  • To investigate sulodexide's potential to reduce biomarkers associated with long-term cardiovascular complications after COVID-19.

Main Methods:

  • A double-blind, randomized, placebo-controlled trial was conducted over 8 weeks.
  • Adult patients in the early convalescent phase of COVID-19 received either sulodexide (250 LRU twice daily) or a placebo.
  • Serum biomarker levels, with Thrombomodulin (TM) as the primary endpoint, were analyzed using repeated measures and post hoc tests.

Main Results:

  • The sulodexide group showed significantly lower mean levels of Thrombomodulin (TM), von Willebrand Factor (vWF), and Interleukin-6 (IL-6) at week 8 compared to placebo.
  • Sulodexide also led to reductions in D-dimer and C-reactive protein (CRP) levels.
  • No significant differences were found for P-selectin, fibrinogen, VCAM-1, or ICAM-1.

Conclusions:

  • Eight weeks of sulodexide treatment in convalescent COVID-19 patients reduced serum levels of TM, vWF, D-dimer, CRP, and IL-6.
  • These findings indicate a potential protective role for sulodexide against post-COVID-19 thromboinflammation and endothelial damage.
  • Sulodexide may offer a therapeutic strategy for managing long-term cardiovascular sequelae of COVID-19.
Abstract

Keywords:
convalescent COVID-19endothelial dysfunctioninflammationlong COVID-19sulodexidethrombomodulin

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