As the world faces a shortage of ventilators to treat critically ill COVID-19 patients in respiratory failure, a group of researchers are launching clinical trials for a drug they hope can treat respiratory failure in COVID-19 patients more effectively.

COVID-19 (SARS-CoV-2) is a coronavirus that causes a respiratory infection in humans and symptoms such as fever, coughing and shortness of breath. In advanced and more serious cases, it can lead to respiratory failure. Currently, the best treatment available for these critically ill patients is the use of a ventilator, which helps the lungs function in hopes the patient will recover.

However, hospitals globally do not have enough ventilators to meet the surge of COVID-19 patients. And in a significant number of cases, people placed on a ventilator with COVID-19 still die, indicating the need for supplemental treatment strategies. Researchers at MIT and the University of Colorado at Denver submitted a paper suggesting that a common medication used to reduce blood clots may help COVID-19 patients in respiratory failure.

These researchers noticed that reports from Italy and China showed that blood clots in the lungs led to respiratory failure in many COVID-19 patients. Based on this data, the researchers want to test tissue plasminogen activator (tPA) medication on COVID-19 patients. Currently, tPA drugs are given to stroke or heart attack patients because it breaks up blood clots. If it works to prevent blood clotting in the lungs, researchers hope it could have an immediate impact on COVID-19 patients.

“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,” says Michael Yaffe, a David H. Koch professor of science at MIT, said in a press release. “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.”

Tissue plasminogen activator has only been tested in humans for respiratory failure in one very small study in 2001. In that study, administering tPA reduced the death rate from 100% to 70%. Yaffe and his colleagues were granted approval for a tPA trial under the Food and Drug Administration’s (FDA) compassionate use program, which allows the use of experimental drugs when there are no other treatment options. Three hospitals — one in Boston and two in Colorado — will participate in the initial clinical trial.

“If it were to work, and we don’t yet know if it will, it has a lot of potential,” Yaffe said. “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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