In our March 24th blog, “Search for a Solution,” we shared a list of nine studies related to COVID-19 that were open for recruitment. A revisit to the website, Clinicaltrials.gov, reveals that the number of studies has now blossomed to 65 in the U.S., and we represent only 15% of the almost 400 studies being conducted worldwide. Outside our borders, the bulk of this research is being done in Europe, with 106 listed studies, and China with 85.
The scope of these efforts range from narrow, focused studies with as few as 10 patients to broad observational studies involving 200,000 people. At the narrow end of the spectrum, there is examination of the specific dynamics of COVID-19 in the HIV infected population, and one focused on cardiovascular complications. There are a series of studies examining differing approaches to managing ICU patients, such as whether Nitric Oxide reduces ventilation/perfusion mismatch or whether Positive End Expiratory Pressure (PEEP) reduces the need for ventilators.
The majority of studies continue to be focused on medical treatments to prevent, cure, or reduce severity of disease related to COVID-19, with Hydroxychloroquine receiving the most attention. In the U.S. alone, 14 of the 65 studies currently described are focused on the use of Hydroxychloroquine, and if you look worldwide, you’ll find 54 separate studies. Antivirals, anti-inflammatories, and other anti-infectious agents continue to lead the list of drugs being explored.
But it isn’t just the infectious disease experts who have gotten involved. There are two particularly interesting studies at the University of Alabama on the use of Tranexamic acid, a lysine derivative, on both outpatient and hospitalized patients with COVID-19. Tranexamic acid, known to inhibit the conversion of plasminogen to plasmin, has been used to reduce postoperative bleeding. Elevated plasmin found in patients with diabetes, hypertension and other chronic diseases has been proposed as the mechanism that puts them at higher risk from COVID-19 by increasing the binding of the virus to human cells. By blocking plasmin formation, tranexamic acid might reduce viral binding to cells and thereby reduce the severity of illness.
If you’re interested in going beyond the highly technical interventions, there are still plenty of COVID-19 related studies for you. Researchers at Wake Forest University are exploring the use of virtual mindfulness meditation services for both patients and providers. Additionally, there are studies on the use of Vitamins C, D, and E, and on natural supplements such as sweet woodworm, evening primrose, and omega-3 fatty acids. Whatever your specific interest or expertise, we encourage you to visit Clinicaltrials.gov to learn more about all that is being done from every possible perspective to ease the burden of this pandemic. It is inspiring to witness such an aligned commitment of expertise and resources to solve the world’s most immediate challenge.