In the midst of all the unproven and ineffective treatments promoted for the treatment of coronaviruses, a new possibility has just emerged.
Scientists around the world are devoting enormous resources to trying to develop new treatments for COVID-19, the pandemic plaguing the world. So far, however, we have not had effective therapies or vaccines.
This may be about to change. What is particularly interesting is that this new treatment uses a widely available drug which has already been shown to be safe for humans.
In a new prepublication, a team of my colleagues from the Johns Hopkins University School of Medicine, led by Maximilian Konig, Bert Vogelstein, Joshua Vogelstein, Susan Athey, Shibin Zhou and Chetan Bettegowda, describes the potential of prazosin to slow and possibly be to prevent one of the worst effects of COVID-19: the cytokine storm.
[Some background: a cytokine storm is an extreme immune response of your own body. When coronavirus (SARS-CoV-2) enters the lungs, your immune system responds with virus-fighting cells that release small proteins called cytokines. In some cases, the immune system just keeps amplifying its response, sending more and more cytokines even though the infection might be under control. If it gets too bad, the cytokine storm itself may be fatal. Cytokine storms have been implicated in other viral diseases, including influenza and SARS.]
Let me start with a caveat: if prazosin works, it is not a cure. However, this could avoid having to use a fan, which would be a huge advantage in a country (and a world) that currently suffers from a severe shortage of fans. Most importantly, it could prevent patients with severe COVID-19 from dying.
Several of the scientists involved in this new study have previously shown that drugs like prazosin (which are technically known as alpha-1AR antagonists) can prevent a cytokine storm in mice. They realized that results in mice often fail to translate into humans, but in the current pandemic, how could they find the time to do a new study?
They did not do so: instead, they searched a medical database and collected the records of 13,125 men who had acute respiratory distress (ARD) from various causes in the years 2007-2015. ARD is not the same as COVID-19, but it is similar; and if a cytokine storm occurs in RAD, patients are more likely to need a ventilator and / or die. Because prazosin is widely used by men (most often for enlarged prostate), they were able to compare the results of men who accidentally took prazosin with those who did not.
The results: men who took prazosin were 22% less likely to need a ventilator or die. It’s not a huge effect, but it could be a game-changer for our busy hospitals in the midst of this pandemic. Even a modest reduction in the number of patients needing respirators – or dying – would be a huge public health victory. In addition, the patients in this retrospective study were not taking prazosin to treat their respiratory distress, and higher doses may have a greater effect.
There are many more caveats here. First, the study I am describing is a preprint of medRxiv, which means that it has not been peer reviewed. In addition, the data comes from a retrospective study of men who had a different disease, not COVID-19. So maybe prazosin will not work to prevent cytokine storms caused by the coronavirus.
But maybe yes. My colleagues have told me about their prepublication because they are convinced that, at the very least, their hypothesis should be examined by as many scientists and doctors as possible. They’re starting their own clinical trial, but they hope these preliminary results “Will inspire immediate clinical trials in countries that are desperately seeking new ways to reduce hospital admissions, ventilation requirements, illness and death.” “
Prazosin has been used for medical purposes since 1974 and is widely available and inexpensive. It is one of the most promising treatments that I have heard of, much more promising than hydroxychloroquine. While this only slightly reduces the need for ventilators, it can have a huge impact on this pandemic. We have to start investigating immediately.
(Note: I have a rule not to write columns on my scientific achievements or those of my colleagues. Many rules are broken in this pandemic, and I decided that the urgency of this potential treatment was more than enough to break my habits. rule.)