Nebulized in-line endotracheal dornase alfa and albuterol administered to mechanically ventilated COVID-19 patients: a case series

Weber, A. G., Chau, A. S., Egeblad, M., Barnes, B. J., Janowitz, T. (September 2020) Nebulized in-line endotracheal dornase alfa and albuterol administered to mechanically ventilated COVID-19 patients: a case series. Mol Med, 26 (1). p. 91. ISSN 1076-1551 (Print)1076-1551

DOI: 10.1186/s10020-020-00215-w


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.

Item Type: Paper
Additional Information: 1528-3658 Weber, Andrew G Chau, Alice S Egeblad, Mikala Barnes, Betsy J Orcid: 0000-0001-6766-4352 Janowitz, Tobias 5P30CA045508-30/CA/NCI NIH HHS/United States 1R01AR076242-01/AR/NIAMS NIH HHS/United States W81XWH-18-1-0674/U.S. Department of Defense/International U54 AI 082973/National Institute of Allergy and Infectious Diseases/International Case Reports Clinical Trial Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. Mol Med. 2020 Sep 29;26(1):91. doi: 10.1186/s10020-020-00215-w.
Subjects: diseases & disorders
diseases & disorders > viral diseases
diseases & disorders > viral diseases > coronavirus
diseases & disorders > viral diseases > coronavirus > covid 19
CSHL Authors:
Communities: CSHL labs > Egeblad lab
CSHL labs > Janowitz lab
Depositing User: Matthew Dunn
Date: 29 September 2020
Date Deposited: 11 Jan 2021 21:28
Last Modified: 01 Feb 2024 19:23
PMCID: PMC7522910
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