Anti-blood clot medication could reduce risk of COVID-19 organ damage

United Kingdom researchers are launching a new trial for a drug that may help prevent dangerous complications associated with severe cases of COVID-19, including lung damage and blood clots.

The medication, called TRV027, was designed to treat heart failure, and experts at the British Heart Foundation and Imperial College London are hopeful it can be repurposed to combat acute bouts of the novel coronavirus.

The initial trial will involve 60 patients in the UK with confirmed or suspected cases of COVID-19. Half the patients will be given the drug, while half will receive a placebo. Researchers will monitor the patients for eight days to ascertain if TRV027 helps prevent damaging symptoms.

Evidence suggests that the novel coronavirus interrupts hormones that control blood pressure. This leads to the blood becoming thicker, which can lead to clotting in the heart and the lungs.

TRV027 works by regulating hormones involved in the circulatory system, and the UK researchers will determine if the drug can counteract the strain that COVID-19 places on blood vessels.

"When this infection was first described, we were surprised to learn that people with heart and circulatory diseases appeared to be at risk," said Kat Pollock, a senior clinical research fellow at Imperial College London who is jointly leading the study.

Heart disease was found to be the most common pre-existing health condition in people who died with COVID-19 during March in England and Wales, according data from the Office of National Statistics.

"We need to move away from thinking of COVID-19 as solely a respiratory illness－it also has devastating effects on the rest of the body including the blood vessels and heart," Pollock added.

TRV027 was developed a decade ago by United States pharmaceutical company Trevena. In May, the company announced that it had received interest from multiple institutions regarding potential studies for TRV027 and COVID-19. The medication joins a long list of existing drugs that researchers are experimenting with during the pandemic, including the anti-malarial treatment hydroxychloroquine and hepatitis C treatment remdesivir.

Studies have shown that novel coronavirus causes infection by entering ACE-2, a protein that sits on the membrane of cells in the lungs and other tissues. ACE-2 plays a crucial role in the Renin-Angiotensin System, or RAS, which regulates blood pressure. Medical experts posit that, by engaging ACE-2 proteins, novel coronavirus disrupts the healthy balance of two hormones, angiotensin II and angiotensin 1-7. Some patients with COVID-19 produce too much angiotensin II, which makes their blood thick, leading to clots.

TRV027 acts by restoring the balance between angiotensin II and angiotensin 1-7.

"People with heart and circulatory diseases are at greater risk of experiencing a more severe illness, and it's vital we find out why and tackle this increased risk," said Nilesh Samani, who is medical director of the British Heart Foundation. "Without an effective vaccine for COVID-19, we urgently need to find new treatments which can reduce the damage caused by this virus."