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Open Access 01-12-2024 | Case report

Nebulized alteplase in coronavirus disease 2019 pneumonia: a case series

Authors: Christopher Milacek, Andreea Nicoleta Stefan, Christina Bal, Matthias Geist, Claudia Guttmann, Marco Idzko, Lukasz Antoniewicz

Published in: Journal of Medical Case Reports | Issue 1/2024

Abstract

Background

Many patients with severe coronavirus disease 2019 pneumonia exhibit signs of microthrombosis. Previous studies discussed intravenous fibrinolytic agents as potential add-on therapy in these patients. Therefore, we propose the inhalative administration of fibrinolytics as a possible safer alternative.

Case presentation

This case series describes five white male patients, aged 51–78 years, treated with off-label inhalation of alteplase between November and December 2020. All patients suffered from severe severe acute respiratory syndrome coronavirus 2 infection with respiratory failure. Pulmonary embolism was ruled out by pulmonary angiogram in computed tomography scans, and all patients showed signs of coronavirus disease 2019 pneumonia. Four patients improved clinically, while one patient with advanced chronic diseases died due to multiple organ failure. No directly associated adverse effects were observed following inhalation of alteplase.

Conclusion

This case series warrants further attention to investigate inhalative alteplase as an additional treatment in patients with severe coronavirus disease 2019 infection.

Available only for authorised users

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Title: Nebulized alteplase in coronavirus disease 2019 pneumonia: a case series
Authors: Christopher Milacek
Andreea Nicoleta Stefan
Christina Bal
Matthias Geist
Claudia Guttmann
Marco Idzko
Lukasz Antoniewicz
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2024
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-024-04924-2

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