IV Metoprolol Safely Improves Oxygenation In COVID-19 Patien
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The administration of intravenous metoprolol in critically ill COVID-19 patients with ARDS is safe, improved oxygenation, and reduced exacerbated lung inflammation, show findings from a pilot trial.

The findings, published in the Journal of the American College of Cardiology (JACC), suggest that repurposing betablocker metoprolol for COVID-19-associated acute respiratory distress syndrome (ARDS) is a safe and inexpensive strategy that can reduce the burden of the COVID-19 pandemic.

Severe COVID can lead to ARDS which involves alveolar infiltration by activated neutrophils. Previous studies have shown metoprolol to improve exacerbated inflammation in the myocardial infarction setting. Agustín ClementeMoragón, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain, and colleagues aimed to evaluate the effects of metoprolol on alveolar inflammation and on respiratory function in patients with COVID-19– associated ARDS.

The study included a total of 20 COVID-19 patients with ARDS on invasive mechanical ventilation. They were randomized to metoprolol (15 mg daily for 3 days) or control (no treatment). All patients underwent bronchoalveolar lavage (BAL) before and after metoprolol/control. Using invasive hemodynamic and electrocardiogram monitoring and echocardiography, the safety of metoprolol administration was evaluated.

The study yielded the following findings:

• Metoprolol administration was without side effects. At baseline, neutrophil content in BAL did not differ between groups. Conversely, patients randomized to metoprolol had significantly fewer neutrophils in BAL on day 4.

• Metoprolol also reduced neutrophil extracellular traps content and other markers of lung inflammation. Oxygenation, whereas it remained unchanged in control subjects.

• Metoprolol-treated patients spent fewer days on invasive mechanical ventilation than those in the control group.

The researchers concluded, our results show that IV administration of metoprolol to patients with severe COVID-19– associated ARDS is safe and abrogates the exacerbated lung inflammation associated with the disease. Reduced lung inflammation was associated with a significant improvement in oxygenation and with a trend toward fewer days on mechanical ventilation and of ICU admission, they wrote.

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Patients BP should support IV metoprolol administration.
Sep 11, 2021Like