A common drug found in many hospitals may reduce the number of deaths caused by infections with the SARS-CoV-2 virus.
A team of researchers has proposed repurposing a drug found in many hospitals around the world to reduce mortality associated with COVID-19.
The research, published in The Journal of Trauma and Acute Care Surgery, could help doctors reduce the significant strain on key hospital resources, such as ventilators, caused by the COVID-19 pandemic.
Some people who contract SARS-CoV-2, the virus that causes COVID-19, will experience only mild to moderate symptoms that means they will not need to go into the hospital.
However, for other people, the virus may become more severe. Sometimes, their condition can be life-threatening.
For patients who are hospitalized, ventilators are a key part of their treatment. There is a range of different ventilators, but their sole purpose is to oxygenate a person’s blood when their body is not able to do so.
This scenario is common in severely ill people where SARS-CoV-2 has affected their lungs, reducing the oxygenation of their blood.
Current estimates suggest that the United States, along with most other parts of the world, does not have enough ventilators to accommodate the number of people with COVID-19 who are likely to require intensive care.
The new research suggests that one way of alleviating the pressure on intensive care units and ventilators is to repurpose a common drug found in many hospitals: tissue plasminogen activator (tPA).
The drug is a type of protein that doctors use to break up blood clots in people who have had a heart attack or a stroke.
Initial data from COVID-19 patients in China and Italy suggests that one of the primary causes of death is significant blood clotting, particularly in the lungs.
According to Michael Yaffe, a David H. Koch Professor of Science at the Massachusetts Institute for Technology and senior author of the research, “If this were to work, which I hope it will, it could potentially be scaled up very quickly, because every hospital already has it in their pharmacy.
“We don’t have to make a new drug, and we don’t have to do the same kind of testing that you would have to do with a new agent. This is a drug that we already use. We’re just trying to repurpose it.”
– Prof. Michael Yaffe
The proposal emerges from years of previous research that has looked into what happens in a person’s lungs during respiratory failure. This research indicates that blood clotting is a key reason for respiratory failure, which stops the oxygenation of a person’s blood.
Prof. Yaffe and the team looked at whether tPA could reduce this blood clotting, given its effectiveness in treating the blood clots of people who have had strokes and heart attacks.
Since a significant number of people with COVID-19 have blood clots, the team hopes that tPA could benefit these people, too.
While the theory has only been applied to one human trial in 2001, the initial results were promising. The trial involved 20 people with respiratory failure who were not expected to survive.
After administering drugs that have the same effect as tPA, 30% survived.
For Prof. Yaffe, “What we are hearing from our intensive care colleagues in Europe and in New York is that many of the critically ill patients with COVID-19 are hypercoagulable, meaning that they are clotting off their IVs, and having kidney and heart failure from blood clots, in addition to lung failure.
“There’s plenty of basic science to support the idea that this concept should be beneficial. The tricky part, of course, is figuring out the right dose and route of administration. But the target we are going after is well-validated.”
– Prof. Michael Yaffe
To test the theory, the team has approval from the Food and Drug Administration’s ‘compassionate use’ program, which allows experimental clinical trials in situations where there are no other treatment options for a patient.
“If it were to work, and we don’t yet know if it will, it has a lot of potential for rapid expansion,” said Prof. Yaffe.
“The public health benefits are obvious. We might get people off ventilators quicker, and we could potentially prevent people from needing to go on a ventilator.”
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