Aminophylline as anti-hypoxic add-on therapy in the management of COVID-19 in Baghdad: An experience from single center report case study

Abstract

Coronavirus has affected people of all ages, gender, and various health status. Persons with chronic diseases or other health conditions may have severe illness from COVID-19. There is no specific drug targeting the coronavirus. Aminophylline is a phosphodiesterase enzyme inhibitor that stimulates the respiratory center and peripherally relaxes the bronchial smooth muscle, which explain its anti-hypoxic effect. This study aimed to show the effect of aminophylline as an anti-hypoxic agent as add-on therapy to the high flow rate oxygen in COVID-19 patients who presented with low blood oxygen. This case managemnt study was carried out in the Army Force Hospital-Respiratory Centre from 10 th April-20 th Augest 2020. Thirty-one patients with severe COVID-19 illness were treated with aminophylline (250-500 mg, slow intravenous infusion, per day) after 2-5 days of respiratory distress. Aminophylline therapy is effective in relieving the hypoxia by elevating the blood saturation with oxygen in 100% (10 out of 10 patients) in COVID-19 patients without evidence of risk factors or concomitant diseases. The effectiveness of aminophylline declined to 81.9% in patients with concomitant diseases, and it was ineffective in 4 patients, three of them survived with artificial ventilation, and one of them was died despite using all supportive measures. In conclusion, Aminophylline as anti-hypoxic agent is associated with improved outcome in severe COVID-19. Its effect is extended to patients with risk factors or concomitant diseases.