- Two doctors have come up with a therapy that might treat the most dangerous coronavirus complication, which can often lead to death.
- The researchers found that T3, a thyroid hormone that the body produces, is absent in the lungs of patients who died of ARDS — respiratory distress that can prove fatal in COVID-19 and other illnesses.
- The doctors obtained approval to test the T3 therapy even before the novel coronavirus was discovered in China. They have administered the drug directly to the lungs of two severe COVID-19 patients, and both of them survived.
- The FDA has cleared the project for a Phase 2 study, aiming to prove the drug is effective in coronavirus-induced ARDS.
The novel coronavirus has been compared with common colds and the flu since late December when this new pneumonia-inducing virus emerged in China. The more we learned about the virus, the more it became clear that COVID-19 is actually nothing like influenza. It’s more contagious and more deadly, and some survivors can end up with chronic conditions they might never shake off.
Moreover, unlike the common cold and influenza, there’s no over-the-counter therapy that works for COVID-19, though doctors have made tremendous progress in treating patients. More and more lives are being saved compared to the first months of the pandemic, but the death toll will remain high as long as the daily number of cases stays high. That’s because doctors still can’t save everyone with the currently available therapies. COVID-19 patients with underlying conditions are at risk of death no matter their age, and it all starts with the lungs. But scientists already have an idea of how to treat the deadly coronavirus complication we all dread.
If you get infected with SARS-CoV-2, you might find yourself experiencing symptoms seen with the flu or a cold. The main difference between COVID-19 and other respiratory illnesses is that you’ll find yourself counting the days and hoping that your immune system can beat the virus before your lungs are compromised. That’s not something you’ll ever experience with the flu. Only COVID-19 will make you consider analyzing your breathing patterns and checking oxygen saturation to determine whether your lungs are working as they should and whether you need to go to the emergency room. And if your condition does worsen and supplemental oxygen is required, there’s no telling what will happen next.
Doctors have already come up with protocols for hospitalized patients. Drugs like remdesivir and dexamethasone can help save lives, but they won’t be effective in every case. Blood thinners are also routinely used in COVID-19 therapy, but they’re not silver bullets that can prevent respiratory failure.
Doctors Tim Rich (Essentia) and David Ingbar (University of Minnesota) have a COVID-19 therapy in Phase 2 trials that might prevent or undo the COVID-19 complication you never want to hear about.
Acute respiratory distress syndrome (ARDS) is a complication seen in various illnesses and doesn’t have a treatment. It’s also the kind of fatal coronavirus complication that can kill COVID-19 patients.
Rich and Ingbar autopsied H1N1 victims in 2009 to study the effects of influenza-related ARDS, and they discovered that the affected lungs lacked T3, a thyroid hormone that should be detectable. The hormone reduces inflammation and helps epithelial cells in the lungs absorb fluids. The problem in ARDS is that lungs get filled with fluid, making the gas exchange impossible.
“A part of this acute lung injury with ARDS is the lungs get leaky, and they tend to fill with fluid,” Ingbar told StarTribune. “That makes it really hard to get oxygen in or carbon dioxide out.”
The doctors received approval to test their ARDS therapy late last year, before the arrival of COVID-19. When it was clear that the novel coronavirus can lead to ARDS and then death, the two proposed the therapy COVID-19 patients experiencing severe complications.
They worked with two middle-aged men, Bob Schlicht (68) and Tim White (51), who both developed severe respiratory issues after contracting the illness in the first months of the pandemic. Both were treated with the T3 hormone and survived the infection. The path to recovery wasn’t necessarily easy, as the younger man spent more than a month in the Duluth hospital and is now in rehab to regain strength so that he can return to work. But his chest X-rays have shown healthy lungs for months.
“This is really a much faster recovery than we see with typical ARDS,” Ingbar told the paper.
“There has been a lot of highly technical science to understand this biology, but the elegance now is in its simplicity,” said Rich. “This is not a designer drug. This is something we know the lung needs and uses.”
On paper, this sounds like the nearly miraculous therapy that could treat the most severe COVID-19 cases. But there’s still a lot to learn. T3 seems to have worked and reversed the symptoms “abruptly,” but only two patients were treated this way. It’s unclear whether T3 is indeed responsible or whether the men could overcome the illness on their own.
The trial was halted for months for a safety review, but the FDA has given the two doctors the go-ahead to enroll more patients. The next stage will include 68 patients, of which 18 will serve as a control group to see whether T3 can save in COVID-induced ARDS.
What’s interesting about the therapy is that it’s not administered intravenously. Instead, doctors send the hormone directly where it’s needed, via a breathing tube that reaches the lungs. The researchers are also working on creating a patented T3 formulation that could be used with a nebulizer. That way, the therapy would be cheaper and easier to administer, and more patients might benefit from it.
If it’s safe and effective, the T3 therapy will not only help COVID-19 patients who develop ARDS, but any other patient suffering from other medical conditions that can ultimately lead to the dangerous respiratory complication.
The doctors also want to see whether administering the treatment earlier can prevent distress to the lungs. The doctors hope that the therapy will save lives and save the actual lungs, allowing patients to return to their previous lives without worrying about chronic lung issues that will need additional therapy.
As with other promising coronavirus drugs in testing, including vaccines, there’s no guarantee that the T3 clinical trials will succeed. Other therapies for coronavirus ARDS are in testing as well.
