Early Use of Bosentan in High Risk COVID-19 Outpatients and Its Impact on Sarcopenia
Nikhil Prasad Fact checked by:Thailand Medical News Team Mar 05, 2025 20 hours, 53 minutes ago
Medical News: COVID-19 has been associated with numerous complications, including the deterioration of muscle mass and function, a condition known as sarcopenia. In high-risk patients, the impact of the virus on muscle health can be severe, leading to long-term consequences. A recent clinical study conducted by researchers from Ilam University of Medical Sciences, Tehran University of Medical Sciences, and Shahid Beheshti University of Medical Sciences in Iran has explored the potential benefits of early bosentan administration in preventing sarcopenia among high-risk COVID-19 outpatients. The study sheds light on how this widely used endothelin receptor blocker might offer protective effects against muscle degradation linked to the disease. This
Medical News report delves into the key findings and implications of this research.
Early Use of Bosentan in High Risk COVID-19 Outpatients and Its Impact on Sarcopenia
Understanding Sarcopenia and COVID-19
Sarcopenia is a condition characterized by a loss of muscle mass, strength, and function, commonly associated with aging but also observed in patients suffering from prolonged illnesses. COVID-19 has been found to contribute to muscle deterioration, particularly due to endothelial damage, inflammation, and increased production of endothelin-1 (ET-1), a potent vasoconstrictor that promotes fibrosis and muscle loss. Researchers hypothesized that blocking ET-1 receptors using bosentan could help mitigate these effects.
Study Design and Participants
The study followed a randomized, double-blind, placebo-controlled trial format, spanning from December 2021 to August 2023. A total of 313 unvaccinated high-risk COVID-19 patients were enrolled within three days of symptom onset. These participants had at least one predisposing risk factor, such as age above 50 years, hypertension, diabetes, chronic lung disease, or obesity. They were randomly assigned to receive either bosentan (62.5 mg twice daily) or a placebo for 30 days.
Key Findings
Researchers followed up with patients at intervals of 3, 6, 9, and 12 months to assess the development of sarcopenia based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. The findings were significant:
-At three months, 13.4% of patients in the placebo group developed sarcopenia compared to only 3.2% in the bosentan group.
-At six months, the sarcopenia rate was 14% in the placebo group versus 3.2% in the bosentan group.
-At nine months, the rates remained at 13.4% for the placebo group and 3.2% for the bosentan group.
-By twelve months, 8.9% of the placebo group had sarcopenia, while only 1.9% of the bosentan-treated patients developed the condition.
These results demonstrated that early bosentan administration significantly reduced the incidence of sarcopenia over a one-year period, suggesting its potential as a preventive strategy for high-risk COVID-19 patients.
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Additional Outcomes and Safety Profile
Beyond sarcopenia prevention, the study also recorded lower hospitalization rates in the bosentan group (1.3%) compared to the placebo group (8%). Additionally, mortality rates were lower in bosentan-treated patients (1.3%) versus 3.8% in the placebo group, although the difference was not statistically significant. Importantly, bosentan was well tolerated, with no severe adverse events reported.
Conclusion
This study highlights the potential of bosentan in reducing the risk of sarcopenia among high-risk COVID-19 outpatients. By targeting endothelin-1, bosentan may help preserve muscle health and improve long-term recovery outcomes for COVID-19 survivors. These findings open the door for further research into repurposing bosentan and other endothelin receptor blockers for muscle preservation in infectious diseases. While more extensive studies are needed to confirm these results, the data strongly suggest that early intervention with bosentan could be beneficial for individuals at risk of muscle deterioration post-COVID-19.
The study findings were published in the peer-reviewed Journal of Cachexia, Sarcopenia and Muscle.
https://onlinelibrary.wiley.com/doi/10.1002/jcsm.13753
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